Summer 2005

Passive Ventricular Support Device Trial

UCSF Medical Center physicians are testing a new passive ventricular support device made of material with more favorable tensile qualities than older devices.

Myocardial infarction can stimulate ventricular remodeling resulting in increased dilatation, thinning of the ventricular wall and loss of myocardial strength. Increased volumes during ventricular filling further decrease myocardial strength, which in turn leads to further increases in ventricular volume. This mechanistic loop can eventually progress to heart failure."

A passive ventricular support device is a stretchy mesh sock-like sheath that fits around the heart. The device keeps the ventricles from dilating too far during filling and assists the muscles during ventricular contraction. "What it does is put the heart back on a more efficacious Frank-Starling curve," says UCSF cardiovascular surgeon Charles Hoopes, M.D.;, referring to the graph describing the relationship between the left ventricle's venous return pressure and its stroke volume. Ventricular contractility and aortic resistance define individual Frank-Starling curves.

One passive ventricular support is the Acorn CorCap device, which is slipped around the heart during open-heart surgery. A clinical trial demonstrated that the CorCap device improved LV function.

The new device being tested at UCSF is manufactured by Paracor. It is similar to the Acorn device, but is made of different materials and is deployed around the heart using a thoracoscopic instrument inserted through a small hole in the chest wall. "This approach has been an advantage not only in being minimally invasive, but you also have a virgin chest if you have to come back years down the road to do a transplant or other procedure," Hoopes says. "You haven't burned any bridges."

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