A Novel Direct Puncture Cannulation Blood Pump Support System: in Vivo Experimental Proof of Concept for a Therapeutic Approach with Cardiac Arrest.

The rate of out-of-hospital cardiac arrest is increasing according to the changes in the proportion of ages in super-aged society. We developed a novel transcutaneous cannulation-type mechanical circulatory system for an alternative therapeutic approach to cardiac arrest using a small centrifugal blood pump. We proposed a transcutaneous mechanical circulatory support capable of rapid installation and quick start of circulatory support for recovery after cardiac arrest by left ventricular direct puncture using the Seldinger technique. The cannula consisted of three components as follows: a) a double-layered cylindrical blood pump housing, b) a centrifugal blood pump impeller primarily installed inside of the cannula, and c) an insertable actuator with magnet coupling. The special feature of the cannula inflow was a backflow resistive unit for adjusting backflow in the process of ventricular puncture. In this study, we performed an in vivo experiment to install the direct cannulation centrifugal blood pump on a goat after cardiac arrest induced by ventricular fibrillation as a proof of concept. As a primary result, the mechanical circulatory support could start in a short period by around one minute installation from the start of cannulation, which could be effective for the recovery after cardiac arrest under the assisted flow of 1.6 L/min at 13,000 rpm of the cannulation pump. Consequently, the novel approach may be useful for the prompt start of mechanical circulatory support.