Carotid Duplex Ultrasound Changes Associated with Left Ventricular Assist Devices

Coutsoumpos, Alexandros; Patel, Sheela T.; Teruya, Theodore H.; Chiriano, Jason; Bianchi, Christian; Abou-Zamzam, Ahmed M.

doi:10.1016/j.avsg.2013.11.013

Cited by 14 publications

(13 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, EDV values were lower in patients with heart failure and higher in patients with LVAD. By continuous‐flow left ventricular support diminished PI with reduced peak systolic flow and increased diastolic flow was demonstrated as in previous studies; however, this diminished pulsatile flow may not alter the cerebral blood flow because increasing EDVs and decreasing PSVs stabilize the PSV to EDV ratio.…”

Section: Discussionsupporting

confidence: 75%

“…Altered blood flow in patients with continuous LVAD may lead to a change in end‐organ perfusion due to reduced pulsatility index (PI). The reflection of this flow in carotid arteries (CA) has been previously reported in several studies; low PI had been shown due to the decrease in peak systolic velocity (PSV) and increase in end‐diastolic velocity (EDV) . However, the relationship between carotid hemodynamic data and cerebral circulation in patients with LVADs still remains an obscure entity.…”

Section: Introductionmentioning

confidence: 98%

See 1 more Smart Citation

Effects of continuous‐flow left ventricular assist devices on cerebral hemodynamics

et al. 2020

View full text Add to dashboard Cite

Continuous-flow left ventricular assist devices (LVADs) reduce peak systolic flow, increase diastolic flow, and eliminate pulsatility of circulation. Altered blood flow may lead to a change in end-organ perfusion. Analysis of the flow dynamics of the arteries of end organs, such as the brain, may indicate whether an organ is perfused sufficiently.The aim of this study is to evaluate and identify the flow pattern changes of carotid (CA) and middle cerebral arteries (MCA) in LVAD patients and to compare with heart failure patients and healthy volunteers. Eighty-nine individuals were included in this cross-sectional study. Participants were divided into three groups: LVAD patients (n = 31), heart failure patients (n = 26), and healthy volunteers (n = 27). Carotid and transcranial Doppler ultrasonography were performed for all study groups for peak systolic velocity (PSV), end-diastolic velocity (EDV), pulsatility (PI), and resistive (RI) indices of CA and MCA. Flow dynamics were compared between the groups. Doppler ultrasonographic data were analyzed at a median 12 (3-47) months after LVAD implantation. CA-PSV was lower in LVAD group compared with the other two groups (P < .001), MCA-PSV of LVAD and heart failure groups were similar and lower than healthy volunteers (P < .05). The highest values for CA-EDV were found in the LVAD group (P < .05). MCA-EDV values were found to be lowest in heart failure group (P < .05). For PI and RI, in all CA and MCA, the LVAD group had lower indices compared with the other two groups (P < .001). In addition, MCA flow analysis in patients with LVADs was identified for the first time with this study. K E Y W O R D Scarotid artery, middle cerebral artery, pulsatility index, resistive index, ventricular assist device 458 | KARAHAN et Al.

show abstract

Section: Discussionsupporting

confidence: 75%

Section: Introductionmentioning

confidence: 98%

Effects of continuous‐flow left ventricular assist devices on cerebral hemodynamics

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Inadequate imaging visualization of aortoiliac arteries and the continuous arterial blood flow due to the LVAD device can lead to difficult detections of PAD lesions in this specific setting . Similarly, the reliability of the ankle‐brachial index, the first‐line noninvasive test for the diagnosis of PAD, has not been proven in this context.…”

Section: Discussionmentioning

confidence: 99%

“…The alteration in normal circulatory physiology after CF‐LVAD implantation makes the evaluation of arterial flow with Doppler ultrasound more challenging. Indeed, the almost complete lack of pulsatility significantly alters the waveforms detected in the peripheral arteries, adversely affecting their interpretation .…”

mentioning

confidence: 99%

Peripheral Artery Disease and Continuous Flow Left Ventricle Assist Device: An Engaging Complement Analysis May Help to Guide Treatment

et al. 2018

View full text Add to dashboard Cite

Use of continuous flow left ventricle assist device (CF-LVAD) in advanced heart failure (HF) patients results in clinically relevant improvements in survival, functional capacity, and quality of life. Peripheral artery disease (PAD) can occur in patients with CF-LVAD due to the high rate of concomitance between risk factors for atherosclerosis and HF. Diagnosis of PAD can be difficult in the specific setting of a patient supported by this kind of device because of the marked alteration in waveform morphology and velocity created by the artificial physiology of an LVAD. We report the case of a 53-year-old man with HF secondary to ischemic cardiomyopathy supported by the HeartWare HVAD as bridge to transplant, who after the implant developed symptoms suggestive of PAD. We describe additional computational flow analysis for the study of PAD-related hemodynamic disturbances induced by a CF-LVAD. Flow simulations enhance the information of clinical image data, and may have an application in clinical investigations of the risk of hemodynamic disturbances induced by LVAD implantation.

show abstract

“…On the other hand, the PSV method also has limitations. For example, PSV cannot be used in cases with high-grade stenosis on the contralateral side 14) or in cases of cardiac disease 15) . Furthermore, the experience of the observer may cause errors in measurement speed due to the characteristics of the ultrasonic device.…”

Section: Discussionmentioning

confidence: 99%

A novel ultrasonography measurement of internal carotid artery stenosis: comparison with the North American Symptomatic Carotid Endarterectomy Trial angiographic method

et al. 2018

View full text Add to dashboard Cite

Carotid Duplex Ultrasound Changes Associated with Left Ventricular Assist Devices

Cited by 14 publications

References 13 publications

Effects of continuous‐flow left ventricular assist devices on cerebral hemodynamics

Effects of continuous‐flow left ventricular assist devices on cerebral hemodynamics

Peripheral Artery Disease and Continuous Flow Left Ventricle Assist Device: An Engaging Complement Analysis May Help to Guide Treatment

A novel ultrasonography measurement of internal carotid artery stenosis: comparison with the North American Symptomatic Carotid Endarterectomy Trial angiographic method

Contact Info

Product

Resources

About