Journal article
Postimplant Left Ventricular Assist Device Fit Analysis Using Three-Dimensional Reconstruction
ASAIO journal (1992), Vol.59(6), pp.586-592
11/01/2013
DOI: 10.1097/MAT.0b013e3182a4b30f
PMID: 24172263
Abstract
Left ventricular assist devices (LVADs) are blood pumps that augment the function of the failing heart to improve perfusion, resulting in improved survival. For LVADs to effectively unload the left ventricle, the inflow cannula (IC) should be unobstructed and ideally aligned with the heart's mitral valve (MV). We examined IC orientation deviation from a hypothesized conventional angle (45 degrees right-posterior) and the approximate angle for direct IC-MV alignment in many patients. Three-dimensional anatomic models were created from computed tomography scans for 24 LVAD-implanted patients, and angles were measured between the IC and the apical z-axis in both the coronal and the sagittal planes. Common surgical IC angulation was found to be 22 +/- 15 degrees rightward and 21 +/- 12 degrees posterior from the apical z-axis; 38% (n = 9) of patients fell in this range. Direct IC-MV angulation was found to be 34 +/- 8 degrees rightward and 15 +/- 7 degrees posterior; only 8% (n = 2) of patients fell in this range. Rightward deviation toward ventricular septal wall and anterior deviation toward LV anterior freewall are associated with mortalities more so than leftward and posterior deviation. In conclusion, anatomic reconstruction may be a useful preoperative tool to obtain general population and patient-specific alignment for optimal LVAD implantation.
Details
- Title: Subtitle
- Postimplant Left Ventricular Assist Device Fit Analysis Using Three-Dimensional Reconstruction
- Creators
- Thang V. Truong - INTEGRIS Baptist Medical CenterJ. Ryan Stanfield - Univ Utah, Dept Mech Engn, Salt Lake City, UT 84112 USAJohn S. Chaffin - INTEGRIS Baptist Med Ctr, Nazhi Zudhi Transplant Inst, Oklahoma City, OK USAC. Craig Elkins - INTEGRIS Baptist Med Ctr, Nazhi Zudhi Transplant Inst, Oklahoma City, OK USAPaul J. Kanaly - INTEGRIS Baptist Med Ctr, Nazhi Zudhi Transplant Inst, Oklahoma City, OK USADouglas A. Horstmanshof - INTEGRIS Baptist Med Ctr, Nazhi Zudhi Transplant Inst, Oklahoma City, OK USAJames W. Long - INTEGRIS Baptist Med Ctr, Nazhi Zudhi Transplant Inst, Oklahoma City, OK USATrevor A. Snyder - INTEGRIS Baptist Med Ctr, Nazhi Zudhi Transplant Inst, Oklahoma City, OK USA
- Resource Type
- Journal article
- Publication Details
- ASAIO journal (1992), Vol.59(6), pp.586-592
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/MAT.0b013e3182a4b30f
- PMID
- 24172263
- ISSN
- 1058-2916
- eISSN
- 1538-943X
- Number of pages
- 7
- Grant note
- Samuel Roberts Noble Foundation
- Language
- English
- Date published
- 11/01/2013
- Academic Unit
- Emergency Medicine
- Record Identifier
- 9984297359502771
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