Late-onset right ventricular dysfunction after mechanical support by a continuous-flow left ventricular assist device

Kapelios, Chris J.; Charitos, Christos; Kaldara, Elisabeth; Malliaras, Konstantinos; Nana, Emmeleia; Pantsios, Christos; Repasos, Evangelos; Tsamatsoulis, Michael; Toumanidis, Savvas; Nanas, John N.

doi:10.1016/j.healun.2015.05.024

Cited by 57 publications

(43 citation statements)

References 20 publications

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“…Moreover, it is known that late-onset RV dysfunction is a complication of LVAD therapy, which has significant adverse implications with regard to patient outcome. 16 Although RV function under epicardial support was already investigated in a previous study, 7 the long-term effects with regards to the functional state of the RV remain to be investigated.…”

Section: Discussionmentioning

confidence: 99%

Individualized Biventricular Epicardial Augmentation Technology in a Drug-Induced Porcine Failing Heart Model

et al. 2018

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For treatment of advanced heart failure, current strategies include cardiac transplantation or blood-contacting pump technology associated with complications, including stroke and bleeding. This study investigated an individualized biventricular epicardial augmentation technology in a drug-induced porcine failing heart model. A total of 11 pigs were used, for the assessment of hemodynamics and cardiac function under various conditions of support pressures and support durations (n = 4), to assess device positioning and function by in vivo computer tomographic imaging (n = 3) and to investigate a minimally invasive implantation on the beating heart (n = 4). Support pressures of 20-80 mm Hg gradually augmented cardiac function parameters in this animal model as indicated by increased left ventricular stroke volume, end-systolic pressures, and decreased end-diastolic pressures. Strong evidence was found regarding the necessity of mechanical synchronization of support end with the isovolumetric relaxation phase of the heart. In addition, the customized, self-expandable implant enabled a marker-guided minimally invasive implantation through a 4 cm skin incision using fluoroscopy. Correct positioning was confirmed in computer tomographic images. Continued long-term survival investigations will deliver preclinical evidence for further development of this concept.

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Section: Discussionmentioning

confidence: 99%

Individualized Biventricular Epicardial Augmentation Technology in a Drug-Induced Porcine Failing Heart Model

et al. 2018

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“…8 Yet, in contrast to ERHF, very few studies have addressed this vexing clinical problem of LRHF in the LVAD-supported patient. 9,10 Furthermore, although LRHF is a concern in all patients who receive an LVAD, it may be of particular importance in those implanted as destination therapy (DT), who are effectively ineligible for heart transplantation and thus have few therapeutic options when LVAD-associated complications such as LRHF occur.…”

Section: See Related Editorial Page 26mentioning

confidence: 99%

“…Whereas the occurrence of early RHF after LVAD implant has been extensively studied, 6,7,[13][14][15][16] only recently have published reports emerged attempting to characterize the phenomenon of LRHF in LVAD patients. 9,10 In 2010, Kormos et al 6 reported the incidence and risk factors of RHF after LVAD implant in the HeartMate II bridge-to-transplant trial. Although patients were stratified into "early" and "late" RHF cohorts, this was effectively a study of early RHF post-LVAD implant because "late" RHF was defined by the need to reinitiate inotropes more than 14 days after LVAD implant but during the same index implant hospitalization.…”

Section: Epidemiology Of Lrhfmentioning

confidence: 99%

The incidence, risk factors, and outcomes associated with late right-sided heart failure in patients supported with an axial-flow left ventricular assist device

Rich

Gošev

Patel

et al. 2017

The Journal of Heart and Lung Transplantation

115

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“…Currently, the effects of LVAD support on the right ventricular function have been paid increasing attentions. Many studies found that the patients, supported by LVAD, have high probability of suffering from right heart failure [ 45 ]. For instance, Gupta et al [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

Computational analysis of the hemodynamic characteristics under interaction influence of β-blocker and LVAD

Zhang

Chang

et al. 2018

BioMed Eng OnLine

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BackgroundHemodynamic characteristics of the interaction influence among support level and model of LVAD, and coupling β-blocker has not been reported.MethodsIn this study, the effect of support level and model of LVAD on cardiovascular hemodynamic characteristics is investigated. In addition, the effect of β-blocker on unloading with LVAD is analyzed to elucidate the mechanism of LVAD coupling β-blocker. A multi-scale model from cell level to system level is proposed. Moreover, LVAD coupling β-blocker has been researching to explain the hemodynamics of cardiovascular system.ResultsMyocardial force was decreased along with the increase of support level of LVAD, and co-pulse mode was the lowest among the three support modes. Additionally, the β-blocker combined with LVAD significantly reduced the left ventricular volume compared with LVAD support without β-blocker. However, the left ventricular pressure under both cases has no significant difference. External work of right ventricular was increased along with the growth of support level of only LVAD. The LVAD under co-pulse mode achieved the lowest right-ventricular EW among the three support modes.ConclusionsCo-pulse mode with β-blocker could be an optimal strategy for promoting cardiac structure and function recovery.

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Late-onset right ventricular dysfunction after mechanical support by a continuous-flow left ventricular assist device

Cited by 57 publications

References 20 publications

Individualized Biventricular Epicardial Augmentation Technology in a Drug-Induced Porcine Failing Heart Model

Individualized Biventricular Epicardial Augmentation Technology in a Drug-Induced Porcine Failing Heart Model

The incidence, risk factors, and outcomes associated with late right-sided heart failure in patients supported with an axial-flow left ventricular assist device

Computational analysis of the hemodynamic characteristics under interaction influence of β-blocker and LVAD

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