Modalities of Left Ventricular Assist Device Optimization

2019 ◽  
pp. 345-352
Author(s):  
Nikhil Narang ◽  
Gabriel Sayer ◽  
Nir Uriel
Keyword(s):  
Aortic Insufficiency ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Left Ventricular Assist ◽  
Hemodynamic Profile ◽  
The Individual ◽  
The Right ◽  
End Stage

Continuous flow left ventricular assist devices (LVADs) are a viable long-term option to the end-stage heart failure patient, with improvements in hemocompatibility seen with newer generation devices. The complex interplay of native myocardial contractility, state of the right ventricle, and presence of aortic insufficiency, among other factors, governs cardiac performance in addition to that from the pump. Deliberate speed adjustments by non-invasive and invasive methods can improve the LVAD hemodynamic profile in a manner tailored to the individual patient. Individualized adjustments in pump parameters by these methods may reduce the longitudinal burden of LVAD-related adverse events.

scholarly journals Sex Differences in Patients Receiving Left Ventricular Assist Devices for End-Stage Heart Failure

2020 ◽  
Vol 8 (9) ◽  
pp. 770-779
Author(s):  
Jadry Gruen ◽  
Cesar Caraballo ◽  
P. Elliott Miller ◽  
Megan McCullough ◽  
Catherine Mezzacappa ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sex Differences ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Assist Devices ◽  
Left Ventricular Assist ◽  
End Stage Heart Failure ◽  
End Stage

Aortic Regurgitation in Patients with Left Ventricular Assist Devices

2019 ◽  
pp. 338-344
Author(s):  
Marisa Cevasco ◽  
Koji Takeda ◽  
Masahiko Ando ◽  
Yoshifumi Naka
Keyword(s):  
Surgical Techniques ◽  
Treatment Strategies ◽  
Aortic Insufficiency ◽  
Left Ventricular ◽  
Adverse Outcomes ◽  
Ventricular Assist Devices ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Assist Devices ◽  
Left Ventricular Assist

Aortic insufficiency (AI) occurs as a complication in 25% to 37% of cases that receive left ventricular assist devices (LVAD). The incidence increases after implant by 1% to 6% per month of continued support. Uncertainty remains over the appropriate management of pump speeds to help delay this deterioration (complete emptying versus allowing native ventricular function open the aortic on a regular basis). Significant AI can lead to hemodynamic impairment with adverse outcomes over time. Due to the recirculation of blood, the calculated cardiac output of the LVAD may be markedly skewed. A number of surgical techniques have been proposed for the prevention and management of AI in the setting of LVAD therapy. This chapter details the causes, treatment strategies, and outcomes associated with this complication.

Computationally Sizing a Left Ventricular Assist Device Graft: A Pre-Procedural Tool to Improve Surgical Outcomes

2020 ◽  
Author(s):  
David A. Ramirez ◽  
Mikayle A. Holm ◽  
Andrew Shaffer ◽  
Paul A. Iaizzo
Keyword(s):  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Left Ventricular Assist Devices ◽  
Assist Device ◽  
Ventricular Assist ◽  
Life Saving ◽  
Improve Life Expectancy ◽  
Left Ventricular Assist ◽  
End Stage Heart Failure ◽  
End Stage

Abstract Implanting Left ventricular assist devices (LVADs) can be life saving therapies that improve life expectancy for the patients that receive it. The target patient population suffer from end-stage heart failure and are therefore susceptible to morbidities arising from a less than ideal surgical implantation. Importantly, the graft that carries the blood from the LVAD pump to the aorta needs to be sized accordingly so as to not cause any compounding complications. The current typical surgical method, is to perform a visual estimation at the time of implantation. This present study proposes a computational tool that utilizes pre-procedural imaging to better calculate the personalized, ideal, LVAD graft length.

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