Left ventricular mechanics of ejecting, postischemic hearts during left ventricular circulatory assistance

Mb, Ratcliffe; Je, Bavaria; Rk, Wenger; Bogen, Daniel K.; Lh, Edmunds

doi:10.1016/s0022-5223(19)36759-5

Cited by 32 publications

(14 citation statements)

References 31 publications

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“…This in turn causes a vicious circle with reduced coronary blood flow and further impairment of LV function (13)(14)(15)(16). Besides contractile reserves, LV loading conditions are critical to maintain forward flow across the aortic valve (17,18). Initiation of femoral veno-arterial ECMO immediately lowers LV preload but elevates LV afterload (13,19,20).…”

Section: Discussionmentioning

confidence: 99%

Nonejecting Hearts on Femoral Veno-Arterial Extracorporeal Membrane Oxygenation: Aortic Root Blood Stasis and Thrombus Formation—A Case Series and Review of the Literature

Hireche-Chikaoui

Grübler

Bloch

et al. 2018

Critical Care Medicine

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Patients in cardiogenic shock who require femoral veno-arterial extracorporeal membrane oxygenation support are at risk of developing a state of nonejecting heart with thrombus formation in the aortic root. Echocardiography is the cornerstone of diagnosis and documentation of treatment effects. Depending on the likelihood of the presence of clinically relevant thrombotic material in the aortic root, we propose a treatment algorithm for this group of high-risk patients.

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Section: Discussionmentioning

confidence: 99%

Nonejecting Hearts on Femoral Veno-Arterial Extracorporeal Membrane Oxygenation: Aortic Root Blood Stasis and Thrombus Formation—A Case Series and Review of the Literature

Hireche-Chikaoui

Grübler

Bloch

et al. 2018

Critical Care Medicine

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“…This can be achieved with concomitant inotrope and IABP use. Persistent ventricular distension and pulmonary hypertension will need to be managed with left ventricle (LV) venting [23].…”

Section: Circuit Designmentioning

confidence: 99%

Mechanical support for high-risk coronary artery bypass grafting

Ali

Abu‐Omar

2018

Indian J Thorac Cardiovasc Surg

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Mechanical circulatory support devices are being used to an increasing extent. The use of these devices as an adjunct to cardiac surgery to support ventricular function has contributed to improved outcomes for the highest risk patients. In the context of patients undergoing coronary artery bypass grafting, there are several potential indications for mechanical circulatory support: preoperatively in the setting of acute cardiogenic shock, or in patients with intractable angina with or without haemodynamic compromise; at induction of anaesthesia prophylactically in patients with critical coronary anatomy and/or severely impaired left ventricular function; intraoperatively in the setting of failure to wean from cardiopulmonary bypass; or postoperatively in patients who develop an intractable low cardiac output state. The use of the intra-aortic balloon pump, veno-arterial extracorporeal membrane oxygenation, TandemHeart, Impella and central ventricular assist devices will be considered in the setting of high-risk patients undergoing coronary artery bypass grafting.

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“…Left ventricular Although left atrial inflow cannulation does not provide the same degree of ventricular unloading as left ventricular apex cannulation (12), an important consideration in patients in whom ventricular recovery is anticipated is that the ventricle not be damaged or compromised by the cannulation itself. Left ventricular assistance using left atrial inflow cannulation has been shown to decrease both end-diastolic and end-systolic volume and reduce circumferential wall stress in poorly contractile postischemic hearts (15). Furthermore, left atrial cannulation is technically easier to perform than left ventricular apex cannulation.…”

Section: Fig 3 This Figure Depicts the Most Common Cannula Configurmentioning

confidence: 99%

Cannula Selection and Cannulation Techniques for Nonpulsatile Mechanical Ventricular Assistance

Richenbacher

Marks

1995

Artificial Organs

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The successful use of mechanical ventricular assistance is, in large part, dependent upon easy insertion of well designed inflow and outflow cannulas. This manuscript describes a family of cannulas specifically designed for use in a nonpulsatile ventricular assist device (VAD) circuit. Although a variety of commercially available cannulas can be employed in a nonpulsatile VAD circuit, the cannulas described in this manuscript possess a number of unique design features. The reinforced thin-walled design and end hole construction optimize fluid flow characteristics in both the inflow and outflow cannula. The extended length allows the cannulas to transverse the skin at a point far distant from the mediastinum, reducing the potential for ascending cannula site infection. The purpose of this manuscript is not to review all cannulas available for nonpulsatile VAD circuits, but rather to describe in detail a family of cannulas that are ideal VAD cannulas based on their design characteristics. In addition individual cardiac surgeons implant very few of these devices annually. Thus the advantages and disadvantages of common cannulation sites and a proven technique for cannula insertion will also be presented.

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Left ventricular mechanics of ejecting, postischemic hearts during left ventricular circulatory assistance

Cited by 32 publications

References 31 publications

Nonejecting Hearts on Femoral Veno-Arterial Extracorporeal Membrane Oxygenation: Aortic Root Blood Stasis and Thrombus Formation—A Case Series and Review of the Literature

Nonejecting Hearts on Femoral Veno-Arterial Extracorporeal Membrane Oxygenation: Aortic Root Blood Stasis and Thrombus Formation—A Case Series and Review of the Literature

Mechanical support for high-risk coronary artery bypass grafting

Cannula Selection and Cannulation Techniques for Nonpulsatile Mechanical Ventricular Assistance

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