The impact of prolonged rotary ventricular assist device support upon ventricular geometry and flow kinetics

Robert M. Weiss, Richard E. Kerber, Jennifer L. Goerbig-Campbell, Melissa K. Davis, Barry M. Cabuay, Ashrith Guha, Wassef Karrowni, James E. Davis, Frances L. Johnson

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)149-156
Number of pages8
JournalJournal of the American Society of Echocardiography
Volume24
Issue number2
DOIs
StatePublished - Feb 1 2011

Keywords

  • Echocardiography
  • Heart assist device
  • Heart failure

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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