(788) A Mock Circulatory Loop Analysis of the Procyrion Aortix Pump

PurposeThe Procyrion Aortix is in clinical trial for the treatment of type I cardiorenal syndrome. We evaluate its impact on cardiovascular hemodynamics in a mock circulatory loop (MCL).MethodsOur MCL is a servo-controlled pneumatic biventricular cardiovascular model, including aortic, pulmonary, coronary and renal circuits, using water/glycerol mixture as blood analogue. Under systolic heart failure conditions, baseline renal flow was titrated to 25% of cardiac output using a clamp that remained fixed throughout the experiments. A fixed voltage was applied to coronary, pulmonary and systemic vascular resistance pinch valves. Primary endpoint was change in renal flow (Qr). Secondary endpoints were changes in intra-aortic gradient (proximal, renal and distal aorta), coronary flow (Qc) and systemic vascular resistance (SVR). All endpoints were evaluated for a range of aortic diameters (32, 25 and 19mm) and pump positions (11, 7 and 3cm proximal to the renal artery ostium).ResultsA difference in Qr was seen by aortic diameter (19mm aorta best) and pump distance (11cm). Percentage increase in Qr in response to maximal pump speed is shown in Figure 1a. At most, Qr increased by 50ml/min (6%). The maximal intra-aortic gradient was 6mmHg from proximal to distal aorta, figure 1b. A small drop in Qc (5-15ml/min) was seen in all experiments. SVR dropped up to 100dynes/s/cm5.ConclusionThe Procyrion Aortix is associated with modest hemodynamic changes in our MCL, suggesting clinical impact may result from neurohumeral modulation in response to increased renal flow, rather than primarily through hemodynamic circulatory support. Its effect on renal flow is seen best in a smaller, more proximal position within the aorta. The Procyrion Aortix is in clinical trial for the treatment of type I cardiorenal syndrome. We evaluate its impact on cardiovascular hemodynamics in a mock circulatory loop (MCL). Our MCL is a servo-controlled pneumatic biventricular cardiovascular model, including aortic, pulmonary, coronary and renal circuits, using water/glycerol mixture as blood analogue. Under systolic heart failure conditions, baseline renal flow was titrated to 25% of cardiac output using a clamp that remained fixed throughout the experiments. A fixed voltage was applied to coronary, pulmonary and systemic vascular resistance pinch valves. Primary endpoint was change in renal flow (Qr). Secondary endpoints were changes in intra-aortic gradient (proximal, renal and distal aorta), coronary flow (Qc) and systemic vascular resistance (SVR). All endpoints were evaluated for a range of aortic diameters (32, 25 and 19mm) and pump positions (11, 7 and 3cm proximal to the renal artery ostium). A difference in Qr was seen by aortic diameter (19mm aorta best) and pump distance (11cm). Percentage increase in Qr in response to maximal pump speed is shown in Figure 1a. At most, Qr increased by 50ml/min (6%). The maximal intra-aortic gradient was 6mmHg from proximal to distal aorta, figure 1b. A small drop in Qc (5-15ml/min) was seen in all experiments. SVR dropped up to 100dynes/s/cm5. The Procyrion Aortix is associated with modest hemodynamic changes in our MCL, suggesting clinical impact may result from neurohumeral modulation in response to increased renal flow, rather than primarily through hemodynamic circulatory support. Its effect on renal flow is seen best in a smaller, more proximal position within the aorta.