Left ventricular function in patients with centrifugal left ventricular assist device

M. S. Verani, M. E. Sekela, John J. Mahmarian, B. Cocanougher, M. E. DeB akey, G. P. Noon

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

We used blood pool radionuclide angiography to study the left ventricular (LV) ejection fraction (EF) in 17 patients with a centrifugal assist device (AD) placed because of severe postoperative LV dysfunction. During maximal LVAD flow, the 12 patients who could be weaned had a higher LV-EF than the 5 who could not be weaned (18 ± 12% vs. 9 ± 2%, p = 0.04). Sequential studies during variable AD flows in 12 patients revealed an increase in LV-EF from 15 ± 7% at maximal flows to 33 ± 8% during minimal flows (p < 0.005) in the 10 patients who could be weaned and no change in LV-EF in 2 patients who could not be weaned. The LV-EF during maximal LVAD flow rates was similar in the 10 patients with long-term survival (192 ± 129 days) and in the 7 patients with only short-term (9 ± 6 days) survival (LV-EF 17 ± 12% vs. 12 ± 6%, p = ns). The long-term survivors, however, had a substantial increase in LV-EF from 20 ± 13% to 34 ± 9% (p < 0.01), as the LVAD flow was decreased from maximal to minimal, whereas the short-term survivors had an insignificant increase in LV-EF from 12 ± 7% to 21 ± 12% (p = ns). The long-term survivors increased the LV-EF from maximal to minimal LVAD flows by 182%, in contrast with the short-term survivors, who increased the LV-EF by only 44%. Furthermore, during this intervention, seven of eigh long-term survivors were able to increase the LV-EF by greater than 100%, in contrast to none of the short-term survivors. Thus, the LV-EF response to manipulations in the AD flow is a major element determining the feasibility of weaning a patient from the LVAD and of long-term survival.

Original languageEnglish (US)
Pages (from-to)544-547
Number of pages4
JournalASAIO Transactions
Volume35
Issue number3
DOIs
StatePublished - 1989

ASJC Scopus subject areas

  • Biophysics

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