Mitral Valve Regurgitation with a Rotary Left Ventricular Assist Device: The Haemodynamic Effect of Inlet Cannulation Site and Speed Modulation

被引：6
|
作者：
Gregory, Shaun D. [1 ,2 ]
Stevens, Michael C. [2 ,3 ]
Wu, Eric L. [1 ,2 ]
Pauls, Jo P. [2 ,4 ]
Kleinheyer, Matthias [2 ,4 ]
Fraser, John F. [1 ,2 ]
机构：
[1] Univ Queensland, Sch Med, Brisbane, Qld, Australia
[2] Prince Charles Hosp, Innovat Cardiovasc Engn & Technol Lab, Crit Care Res Grp, Brisbane, Qld, Australia
[3] Univ New South Wales, Grad Sch Biomed Engn, Sydney, NSW, Australia
[4] Griffith Univ, Sch Engn, Southport, Qld, Australia
来源：
ANNALS OF BIOMEDICAL ENGINEERING | 2016年 / 44卷 / 09期
基金：
英国医学研究理事会;
关键词：
Ventricular assist device; Mitral valve regurgitation; Speed modulation; Cannula; Heart failure; MOCK CIRCULATION LOOP; BLOOD PUMPS; TRICUSPID REGURGITATION; AORTIC-INSUFFICIENCY; IMPLANTATION; PULSATILE; HEART; SIMULATION; FEATURES; MODE;
D O I：
10.1007/s10439-016-1579-5
中图分类号：
R318 [生物医学工程];
学科分类号：
0831 ;
摘要：
Mitral valve regurgitation (MVR) is common in patients receiving left ventricular assist device (LVAD) support, however the haemodynamic effect of MVR is not entirely clear. This study evaluated the haemodynamic effect of MVR with LVAD support and the influence of inflow cannulation site and LVAD speed modulation. Left atrial (LAC) and ventricular (LVC) cannulation was evaluated in a mock circulation loop with no, mild, moderate and severe MVR with constant speed and speed modulation (+/- 600 RPM) modes. The use of an LVAD relieved pulmonary congestion during severe MVR, by reducing left atrial pressure from 20.5 to 10.8 (LAC) and 11.5 (LVC) mmHg. However, LAC resulted in decreased left ventricular stroke work (-0.08 J), ejection fraction (-7.9%) and higher MVR volume (+ 12.7 mL) and pump speed (+ 100 RPM) compared to LVC. This suggests that LVC, in addition to reducing MVR severity, also improves ventricular washout over LAC. LVAD speed modulation in synchrony with ventricular systole reduced MVR volume and increased ejection fraction with LAC and LVC, thus demonstrating the potential benefits of this mode, despite a reduction in cardiac output.
引用
收藏
页码：2674 / 2682
页数：9
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