Document Detail


Left ventricular assist device malfunction: a systematic approach to diagnosis.
MedLine Citation:
PMID:  15120814     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: A protocol was designed to diagnose the common malfunctions of a left ventricular assist device (LVAD). BACKGROUND: Mechanical circulatory support, primarily with an LVAD, is increasingly used for treatment of advanced heart failure (HF). Left ventricular assist device dysfunction is a recognized complication; but heretofore, a systematic method to accurately diagnose LVAD dysfunction has not been thoroughly described. METHODS: We developed a catheter-based protocol designed to characterize a normally functioning LVAD and diagnose multiple types of dysfunction. A total of 15 studies of 10 patients supported with an LVAD were reviewed. All patients had been evaluated due to concerns regarding LVAD dysfunction. RESULTS: Of 15 examinations performed, 11 documented severe LVAD inflow valve regurgitation. One of these cases proved to have coexistent severe mitral valve regurgitation. One case was diagnosed with distortion of the LVAD outflow graft. One case of suspected embolization from the pumping chamber excluded the outflow graft as the source of emboli. One study had aortic insufficiency. CONCLUSIONS: As LVAD use for treatment of end-stage HF becomes widespread and durations of support are extended, dysfunction will be increasingly prevalent. This catheter-based protocol provided a practical method to diagnose multiple causes of LVAD dysfunction.
Authors:
Steven C Horton; Reza Khodaverdian; Amanda Powers; James Revenaugh; Dale G Renlund; Stephanie A Moore; Brad Rasmusson; Karl E Nelson; James W Long
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  43     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-05-03     Completed Date:  2004-06-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1574-83     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, LDS Hospital and University of Utah School of Medicine, Salt Lake City, 84103, USA. SCHorton@msn.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aortic Valve Insufficiency / diagnosis,  etiology,  physiopathology
Aortic Valve Stenosis / diagnosis,  etiology,  physiopathology
Cardiac Output / physiology
Cardiomyopathy, Dilated / physiopathology,  surgery
Coronary Angiography
Coronary Circulation / physiology
Echocardiography, Doppler
Electrocardiography
Equipment Design
Equipment Failure
Female
Heart Ventricles / surgery*
Heart-Assist Devices*
Humans
Male
Middle Aged
Mitral Valve Insufficiency / diagnosis,  etiology,  physiopathology
Myocardial Ischemia / physiopathology,  surgery
Postoperative Complications / diagnosis,  etiology,  physiopathology
Pulmonary Wedge Pressure / physiology
Statistics as Topic
Thromboembolism / diagnosis,  etiology,  physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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