Journal article
The Impact of Prolonged Rotary Ventricular Assist Device Support upon Ventricular Geometry and Flow Kinetics
Journal of the American Society of Echocardiography, Vol.24(2), pp.149-156
2011
DOI: 10.1016/j.echo.2010.10.009
PMID: 21093217
Abstract
The aim of this study was to determine the impact of prolonged left ventricular assist device (VAD) support on cardiac ventricular geometry and VAD flow kinetics.
Nineteen patients with end-stage heart failure underwent the implantation of HeartMate II rotary flow VADs. Left and right ventricular geometry and VAD flow kinetics were assessed by transthoracic echocardiography early (7 ± 1 days) and late (113 ± 21 days) after VAD implantation.
Left ventricular end-diastolic internal dimension decreased by 21% and 35%, respectively, early and late after VAD implantation (
n = 19;
P < .001 vs before VAD implantation). Right ventricular end-diastolic internal dimension did not decrease at either time. Hemodynamic trends were similar. VAD inflow obstruction by myocardium was observed in eight patients, seven of whom demonstrated significantly increased variation of VAD inflow during the cardiac cycle (“pulsatility”) detected by Doppler studies. Medical or surgical intervention returned VAD flow patterns toward baseline in seven of eight patients with VAD obstructions.
Prolonged rotary VAD support unloads the left ventricle, with modest effects on the right ventricle. These changes are often associated with alterations of VAD flow kinetics, requiring therapeutic intervention. These findings indicate the usefulness of echocardiographic surveillance in patients undergoing prolonged VAD support.
Details
- Title: Subtitle
- The Impact of Prolonged Rotary Ventricular Assist Device Support upon Ventricular Geometry and Flow Kinetics
- Creators
- Robert M Weiss - Division of Cardiovascular Medicine, Carver College of Medicine, University of Iowa, Iowa City, IowaRichard E Kerber - Division of Cardiovascular Medicine, Carver College of Medicine, University of Iowa, Iowa City, IowaJennifer L Goerbig-Campbell - Division of Cardiovascular Medicine, Carver College of Medicine, University of Iowa, Iowa City, IowaMelissa K Davis - Division of Cardiovascular Medicine, Carver College of Medicine, University of Iowa, Iowa City, IowaBarry M Cabuay - Minneapolis Heart Institute, Minneapolis, MinnesotaGuha Ashrith - Division of Cardiovascular Medicine, Carver College of Medicine, University of Iowa, Iowa City, IowaWassef Karrowni - Division of Cardiovascular Medicine, Carver College of Medicine, University of Iowa, Iowa City, IowaJames E Davis - Department of Thoracic and Cardiovascular Surgery, Carver College of Medicine, University of Iowa, Iowa City, IowaFrances L Johnson - Division of Cardiovascular Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of the American Society of Echocardiography, Vol.24(2), pp.149-156
- Publisher
- Mosby, Inc
- DOI
- 10.1016/j.echo.2010.10.009
- PMID
- 21093217
- ISSN
- 0894-7317
- eISSN
- 1097-6795
- Language
- English
- Date published
- 2011
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984094595102771
Metrics
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