Heart Failure Reviews

, Volume 10, Issue 2, pp 101–107 | Cite as

Design and Features of the Acorn CorCapTM Cardiac Support Device: The Concept of Passive Mechanical Diastolic Support



The Laplace equation points to the importance of ventricular wall stress as a factor in heart failure development and progression. Based on animal and clinical experience with active and passive cardiomyoplasty, a synthetic passive constraint was proposed as a means of reducing excessive wall stress, and thus assuaging disease progression. The Acorn CorCapTM CSD Cardiac Support Device was designed to provide passive diastolic support and serve as a constraint against chronic cardiac dilation in heart failure. Basic and uncomplicated in appearance, the device nevertheless incorporates numerous sophisticated structural and functional features intended maximize therapeutic value. The device is fabricated from medical grade multifilament polyester yarn, in a specific knit construction chosen to provide structural integrity, low physical profile, pliability for intimate contact with the epicardial surface, ease of manipulation during implantation, and anisotropic compliance characteristics to encourage beneficial reverse remodeling.


CorCapTM cardiac support device heart failure passive constraint wall stress compliance 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Packer M. The impossible task of developing a new treatment for heart failure. J Cardiac Failure 2002;8(4):193–196.CrossRefGoogle Scholar
  2. 2.
    Chen FY, Cohn LH. The surgical treatment of heart failure. A new frontier: Nontransplant surgical alternatives in heart failure. Cardiol Rev 2002;10(8):326–333.CrossRefPubMedGoogle Scholar
  3. 3.
    Loebe M, Soltero E, Thohan V, Lafuente JA, Noon Gp. New surgical therapies for heart failure. Curr Opin Cardiol 2003;18:194–198.CrossRefPubMedGoogle Scholar
  4. 4.
    Auricchio A, Stellbrink C, Sack S, Block M, Vogt J, Bakker P, Huth C, Schondube F, Wolfhard U, Bocker D, Krahnefeld O, Kirkels H; Pacing Therapies in Congestive Heart Failure (PATH-CHF) Study Group. Long-term clinical effect of hemodynamically optimized cardiac resynchronization therapy in patients with heart failure and ventricular conduction delay. J Am Coll Cardiol 2002;39(12):2026–2033.CrossRefPubMedGoogle Scholar
  5. 5.
    Abraham WT, Fisher WG, Smith AL, Delurgio DB, Leon AR, Loh E, Kocovic DZ, Packer M, Clavell AL, Hayes DL, Ellestad M, Trupp RJ, Underwood J, Pickering F, Truex C, McAtee P, Messenger J; MIRACLE Study Group. Multicenter InSync Randomized Clinical Evaluation. Cardiac resynchronization in chronic heart failure. N Engl J Med 2002;346(24):1845–1853.CrossRefPubMedGoogle Scholar
  6. 6.
    Magovern GJ, Simpson KA, Magovern JA, Magovern GJ Sr. Surgical therapy for heart failure. In: Rose EA, Stevenson LW, eds. Management of End-Stage Heart Disease. Philadelphia: Lippincott-Raven Publishers, 1998:231–239.Google Scholar
  7. 7.
    Magovern GJ, et al., 1998.Google Scholar
  8. 8.
    Chachques JC, Berrebi A, Hernigou A, Cohen-Solal A, Lavergne T, Marino JP, D'Attellis N, Bensasson D, Carpentier A. Study of muscular and ventricular function in dynamic cardiomyoplasty: A ten-year follow-up. J Heart Lung Transplant 1997;16:854–868.PubMedGoogle Scholar
  9. 9.
    Lorusso R, Milan E, Volterrani M, Giubbini R, van der Veen FH, Schreuder JJ, Picchioni A, Alfieri O. Cardiomyoplasty as an isolated procedure to treat refractory heart failure. Eur J Cardiothorac Surg 1997;11:363–372.CrossRefPubMedGoogle Scholar
  10. 10.
    Oh JH, Badhwar V, Chiu RC. Mechanisms of dynamic cardiomyoplasty: Current concepts. J Card Surg 1996;11:194–199.PubMedGoogle Scholar
  11. 11.
    El Oakley RM, Jarfis JC. Cardiomyoplasty: A critical review of experimental and clinical results. Circ 1994;90:2085–2090.Google Scholar
  12. 12.
    Capouya ER, Gerber RS, Drinkwater DC, Pearl JM, Sack JB, Aharon AS, Barthel SW, Kaczer EM, Chang PA, Laks H. Girdling effect of nonstimulated cardiomyoplasty on left ventricular function. Ann Thorac Surg 1993;56:867–871.PubMedGoogle Scholar
  13. 13.
    Shabetai R. Function. In: Fowler NO, ed. The Pericardium in Health and Disease. Mount Kisco, NY: Futura. 1985;19–50.Google Scholar
  14. 14.
    Shabetai R. Function of the normal pericardium. Clin Cardiol 1999;22(1 Suppl 1):I4–I5.PubMedGoogle Scholar
  15. 15.
    Freeman GL. The effects of the pericardium on function of normal and enlarged hearts. Cardiol Clin 1990;8(4):579–586.PubMedGoogle Scholar
  16. 16.
    Freeman GL, LeWinter MM. Pericardial adaptations during chronic cardiac dilation in dogs. Circ Res 1984;54(3):294–300.PubMedGoogle Scholar
  17. 17.
    Capouya ER, Gerber RS, Drinkwater DC, Pearl JM, Sack JB, Aharon AS, Barthel SW, Kaczer EM, Chang PA, Laks H. Girdling effect of nonstimulated cardiomyoplasty on left ventricular function. Ann Thorac Surg 1993;56:867–871.PubMedGoogle Scholar
  18. 18.
    Vaynblat M, Chiavarelli M, Shah HR, Ramdev G, Aron M, Zisbrod Z, Cunningham JN Jr. Cardiac binding in experimental heart failure. Ann Thorac Surg 1997;64:81–85.CrossRefPubMedGoogle Scholar
  19. 19.
    Patel HJ, Polidori DJ, Pilla JJ, Plappert T, Kass D, St. John Sutton M, Lankford EB, Acker MA. Stabilization of chronic remodeling by asynchronous cardiomyoplasty in dilated cardiomyopathy: Effects of a conditioned muscle wrap. Circ 1997;96:3665–3671.Google Scholar
  20. 20.
    Oh JH, Badhwar V, Mott BD, Li CM, Chiu RC-J. The effects of prosthetic cardiac binding and adynamic cardiomyoplasty in a model of dilated cardiomyopathy. J Thorac Cardiovasc Surg 1998;116:148–153.PubMedGoogle Scholar
  21. 21.
    Kass DA, Baughman KL, Pak PH, Cho PW, Levin HR, Gardner TJ, Halperin HR, Tsitlik JE, Acker MA. Reverse remodeling from cardiomyoplasty in human heart failure: External constraint versus active assist. Circ 1995;91:2314–2318.PubMedGoogle Scholar
  22. 22.
    Hagege AA, Desnos M, Fernandez F, Besse B, Mirochnik N, Castaldo M, Chachques JC, Carpentier A, Guerot C. Clinical study of the effects of latissimus dorsi muscle flap stimulation after cardiomyoplasty. Circ 1995;92(9 Suppl):II-210-II-215.Google Scholar
  23. 23.
    Patel HJ, Lankford EB, Polidori DJ, Pilla JJ, Plappert T, Sutton MSJ, Acker MA. Dynamic cardiomyoplasty: Its chronic and acute effects on the failing heart. J Thorac Cardiovasc Surg 1997;114:169–178.PubMedGoogle Scholar
  24. 24.
    Kass DA, et al., 1995.Google Scholar
  25. 25.
    Leier CV. Cardiomyoplasty: Is it time to wrap it up? J Am Coll Cardiol 1997;28:1182–1183.Google Scholar
  26. 26.
    Vaynblat M, et al., 1997.Google Scholar
  27. 27.
    Oh JH, et al., 1998.Google Scholar
  28. 28.
    Chaudhry PA, Mishima T, Sharov VG, Hawkins J, Alferness C, Paone G, Sabbah HN. Passive epicardial containment prevents ventricular remodeling in heart failure. Ann Thorac Surg 2000;70:1275–1280.CrossRefPubMedGoogle Scholar
  29. 29.
    Saavedra WF, Tunin RS, Paolocci N, Mishima T, Suzuki G, Emala CW, Chaudhry PA, Anagnostopoulos P, Gupta RC, Sabbah HN, Kass DA. Reverse remodeling and enhanced adrenergic reserve from passive external support in experimental dilated heart failure. J Am Coll Cardiol 2002 Jun 19;39(12):2069–76.CrossRefGoogle Scholar
  30. 30.
    Oz MC, Konertz WF, Kleber FX, Mohr FW, Gummert JF, Ostermeyer J, Lass M, Raman J, Acker MA, Smedira N. Global surgical experience with the Acorn cardiac support device. J Thorac Cardiovasc Surg 2003 Oct;126(4):983–991.Google Scholar
  31. 31.
    Mary C, Marois Y, King MW, Hong T, Laroche G, Douville Y, Martin L, Guidoin R: In vitro and in vivo studies of a polyester arterial prosthesis with a warp-knitted sharkskin structure. J Biomed Mater Res 1997;35:459–472.CrossRefPubMedGoogle Scholar
  32. 32.
    Seitz H, Marlovits S, Schwendenwein I, Muller E, Vecsei V: Biocompatibility of polyethylene terephthalate (Trevira hochfest) augmentation device in repair of the anterior cruciate ligament. Biomaterials 1998;19:189–196.CrossRefPubMedGoogle Scholar
  33. 33.
    Guidoin RG, King M, Marois M, Martin L, Marceau D, Hood R, Maini R: New polyester arterial prostheses from Great Britain: An in vitro and in vivo evaluation. Ann Biomed Eng 1986;14:351–367.PubMedGoogle Scholar
  34. 34.
    D.F. Paling, Warp Knitting Technology, p. 111. Buxton, Great Britain: Columbine Press Ltd., 1970.Google Scholar
  35. 35.
    Nunn DB: Structural failure of Dacron arterial grafts. Semin Vasc Surg 1999;12:83–91.PubMedGoogle Scholar
  36. 36.
    Vinard E, Eloy R, Descotes J, Brudon JR, Guidicelli H, Magne JL, Patra P, Berruet R, Huc A, Chauchard J: Stability of performances of vascular prostheses retrospective study of 22 cases of human implanted prostheses. J Biomed Mater Res 1988;22:633–648.CrossRefPubMedGoogle Scholar
  37. 37.
    Riepe G, Loos J, Imag H, Schroder A, Schneider E, Permann J, Rogge A, Ludwig M, Schenke A, Nassutt R, Chakfe N, Morlock M: Long-term in vivo alterations of polyester vascular grafts in humans. Eur J Vasc Endovasc Surg 1997;13:540–548.CrossRefPubMedGoogle Scholar
  38. 38.
    Francis GS. Neurohumoral activation and progression of heart failure: Hypothetical and clinical considerations. J Cardiovasc Pharmacol 1998;32(Suppl 1):S16–S21.CrossRefPubMedGoogle Scholar
  39. 39.
    Middlekauff HR. Mechanisms and implications of autonomic nervous system dysfunction in heart failure. Curr Opin Cardiol 1997;12(3):265–275.PubMedGoogle Scholar
  40. 40.
    Baig MK, Mahon N, McKenna WJ, Caforio ALP, Bonow RO, Francis GS, Gheorghiade M. The pathophysiology of advanced heart failure. Heart & Lung 1999;28:87–101.Google Scholar
  41. 41.
    Dreifuss P. therapy of terminal dilated cardiomyopathy with growth hormone. Z Kardiol 1998;87:425–435.CrossRefPubMedGoogle Scholar
  42. 42.
    Pfeffer MA, Braunwald E. Ventricular remodeling after myocardial infarction. Experimental observations and clinical implications. Circ 1990;81:1161–1172.PubMedGoogle Scholar
  43. 43.
    Baig, MK, et al., 1999.Google Scholar
  44. 44.
    Testing according to ASTM Standard D3787–89.Google Scholar

Copyright information

© Springer Science + Business Media, Inc. 2005

Authors and Affiliations

  1. 1.Acorn Cardiovascular, Inc.St. Paul

Personalised recommendations