イイヅカ　ケイ   Iidzuka Kei   飯塚　慶    所属   医学部 医学科（東京女子医科大学病院）    職種   助教
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	The angle of the outflow graft to the aorta can affect recirculation due to aortic insufficiency under left ventricular assist device support.
掲載誌名	正式名：Journal of Artificial Organs 略　 称：J Artif Organs ISSNコード：1434-7229/1619-0904
掲載区分	国内
出版社	The Japanese Society for Artificial Organs
巻・号・頁	21(4),pp.399-404
著者・共著者	IIZUKA Kei†, NISHINAKA Tomohiro, AKIYAMA Daichi, SUMIKURA Hirohito, MIZUNO Toshihide, TSUKIYA Tomonori, TAKEWA Yoshiaki, YAMAZAKI Kenji, TATSUMI Eisuke
担当区分	筆頭著者
発行年月	2018/12
概要	Aortic insufficiency (AI) is a crucial complication during continuous-flow left ventricular assist device (LVAD) support. Our previous clinical study suggested that a larger angle between the outflow graft and the aorta (O-A angle) could cause AI progression. This study examined the effect of the O-A angle on the hemodynamics of AI under LVAD support in an acute animal experimental model. An LVAD was installed in seven calves, with the inflow cannula inserted from the LV apex and with the outflow graft sutured at the ascending aorta. The AI model was made using a temporary inferior vena cava filter inserted from the LV apex and placed at the aortic valve. Cardiac dysfunction was induced by continuous beta-blocker infusion. Hemodynamic values and the myocardial oxygen extraction rate (O2ER) were evaluated at three O-A angles (45°, 90°, and 135°) over three levels of AI (none, Sellers I-II AI, and Sellers III-IV AI). The recirculation rate, defined as the percentage of regurgitation flow to LVAD output, was calculated. Systemic flow tended to decrease with a larger O-A angle. The recirculation rate was significantly increased with a larger O-A angle (22, 23, and 31% at 45°, 90°, and 135° in Sellers III-IV AI, respectively). Coronary artery flow was decreased at a larger O-A angle (86, 76 and 75 mL/min at 45°, 90°, and 135° in Sellers I-II AI, respectively, and 77, 67, and 56 mL/min at 45°, 90°, and 135° in Sellers III-IV AI, respectively). O2ER tended to increase with a larger O-A angle (40, 43, and 49% at 45°, 90°, and 135° in Sellers III-IV AI, respectively). A larger O-A angle can increase the recirculation due to AI and can be disadvantageous to LVAD-AI hemodynamics and myocardial oxygen metabolism.
DOI	10.1007/s10047-018-1064-z
PMID	30039455