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Assessment of timing right ventricular assist device withdrawal using left ventricular assist device filling characteristics.
ASAIO J. 1997 Sep-Oct; 43(5):M801-5.AJ

Abstract

Right ventricular assist devices (RVAD) are often needed on a short term basis in patients who develop RV failure after left ventricular assist device (LVAD) implantation. The purpose of this study was to use LVAD filling characteristics to help determine the timing for weaning a patient from RVAD support. Eleven patients (age 50 years +/- 15) supported with an LVAD (Novacor) and an RVAD (Biomedicus or ABIOMED) were studied. Eight patients (RV recovery group) were studied before RVAD removal and all were successfully weaned from RVAD support. Five patients (RV failure group) were studied at the time of RVAD placement to determine baseline characteristics of RV failure. Simultaneous measures of LVAD volume and routine hemodynamics were recorded during periods of high and low RVAD flow. The LVAD filling was assessed as the first derivative of LVAD volume and the mean filling rate for each cardiac cycle was calculated and averaged over 10 sec periods at both RVAD flows. The mean pump rate corrected filling rates did not change in the RV recovery group (89 +/- 13 vs. 87 +/- 8 ml/beat) and significantly decreased in the RV failure group (84 +/- 19 vs. 62 +/- 22 ml/ beat) (p < 0.001) with decreasing RVAD flow. These data suggest that LVAD filling rates may be used to assess RV systolic function and the proper timing of RVAD removal in selected patients.

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Authors+Show Affiliations

Mandarino WA
Division of Cardiothoracic Surgery, University of Pittsburgh, PA, USA.
Winowich S
No affiliation info available
Gasior TA
No affiliation info available
Pham S
No affiliation info available
Griffith BP
No affiliation info available
Kormos RL
No affiliation info available

MeSH

AdultAgedHeart FailureHeart-Assist DevicesHemodynamicsHumansMiddle AgedTime FactorsVentricular Dysfunction, LeftVentricular Dysfunction, Right

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9360157

Citation

Mandarino, W A., et al. "Assessment of Timing Right Ventricular Assist Device Withdrawal Using Left Ventricular Assist Device Filling Characteristics." ASAIO Journal (American Society for Artificial Internal Organs : 1992), vol. 43, no. 5, 1997, pp. M801-5.
Mandarino WA, Winowich S, Gasior TA, et al. Assessment of timing right ventricular assist device withdrawal using left ventricular assist device filling characteristics. ASAIO J. 1997;43(5):M801-5.
Mandarino, W. A., Winowich, S., Gasior, T. A., Pham, S., Griffith, B. P., & Kormos, R. L. (1997). Assessment of timing right ventricular assist device withdrawal using left ventricular assist device filling characteristics. ASAIO Journal (American Society for Artificial Internal Organs : 1992), 43(5), M801-5.
Mandarino WA, et al. Assessment of Timing Right Ventricular Assist Device Withdrawal Using Left Ventricular Assist Device Filling Characteristics. ASAIO J. 1997 Sep-Oct;43(5):M801-5. PubMed PMID: 9360157.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessment of timing right ventricular assist device withdrawal using left ventricular assist device filling characteristics. AU - Mandarino,W A, AU - Winowich,S, AU - Gasior,T A, AU - Pham,S, AU - Griffith,B P, AU - Kormos,R L, PY - 1997/11/14/pubmed PY - 1997/11/14/medline PY - 1997/11/14/entrez SP - M801 EP - 5 JF - ASAIO journal (American Society for Artificial Internal Organs : 1992) JO - ASAIO J VL - 43 IS - 5 N2 - Right ventricular assist devices (RVAD) are often needed on a short term basis in patients who develop RV failure after left ventricular assist device (LVAD) implantation. The purpose of this study was to use LVAD filling characteristics to help determine the timing for weaning a patient from RVAD support. Eleven patients (age 50 years +/- 15) supported with an LVAD (Novacor) and an RVAD (Biomedicus or ABIOMED) were studied. Eight patients (RV recovery group) were studied before RVAD removal and all were successfully weaned from RVAD support. Five patients (RV failure group) were studied at the time of RVAD placement to determine baseline characteristics of RV failure. Simultaneous measures of LVAD volume and routine hemodynamics were recorded during periods of high and low RVAD flow. The LVAD filling was assessed as the first derivative of LVAD volume and the mean filling rate for each cardiac cycle was calculated and averaged over 10 sec periods at both RVAD flows. The mean pump rate corrected filling rates did not change in the RV recovery group (89 +/- 13 vs. 87 +/- 8 ml/beat) and significantly decreased in the RV failure group (84 +/- 19 vs. 62 +/- 22 ml/ beat) (p < 0.001) with decreasing RVAD flow. These data suggest that LVAD filling rates may be used to assess RV systolic function and the proper timing of RVAD removal in selected patients. SN - 1058-2916 UR - https://www.unboundmedicine.com/medline/citation/9360157/Assessment_of_timing_right_ventricular_assist_device_withdrawal_using_left_ventricular_assist_device_filling_characteristics_ L2 - https://Insights.ovid.com/pubmed?pmid=9360157 DB - PRIME DP - Unbound Medicine ER -