Document Detail


The Impact of Prolonged Rotary Ventricular Assist Device Support upon Ventricular Geometry and Flow Kinetics.
MedLine Citation:
PMID:  21093217     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
Authors:
Robert M Weiss; Richard E Kerber; Jennifer L Goerbig-Campbell; Melissa K Davis; Barry M Cabuay; Guha Ashrith; Wassef Karrowni; James E Davis; Frances L Johnson
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Publication Detail:
Type:  Journal Article     Date:  2010-11-18
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  24     ISSN:  1097-6795     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  149-56     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.
Affiliation:
Division of Cardiovascular Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa.
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