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Ventricular and Atrial Pressure—Volume Loops: Analysis of the Effects Induced by Right Centrifugal Pump Assistance
The main indications for right ventricular assist device (RVAD) support are right heart failure after implantation of a left ventricular assist device (LVAD) or early graft failure following heart transplantation. We sought to study the effects induced by different RVAD connections when right ventri...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9137510/ https://www.ncbi.nlm.nih.gov/pubmed/35621459 http://dx.doi.org/10.3390/bioengineering9050181 |
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author | De Lazzari, Beatrice Iacovoni, Attilio Capoccia, Massimo Papa, Silvia Badagliacca, Roberto Filomena, Domenico De Lazzari, Claudio |
author_facet | De Lazzari, Beatrice Iacovoni, Attilio Capoccia, Massimo Papa, Silvia Badagliacca, Roberto Filomena, Domenico De Lazzari, Claudio |
author_sort | De Lazzari, Beatrice |
collection | PubMed |
description | The main indications for right ventricular assist device (RVAD) support are right heart failure after implantation of a left ventricular assist device (LVAD) or early graft failure following heart transplantation. We sought to study the effects induced by different RVAD connections when right ventricular elastance (Ees(RIGHT)) was modified using numerical simulations based on atrial and ventricular pressure–volume analysis. We considered the effects induced by continuous-flow RVAD support on left/right ventricular/atrial loops when Ees(RIGHT) changed from 0.3 to 0.8 mmHg/mL during in-series or parallel pump connection. Pump rotational speed was also addressed. Parallel RVAD support at 4000 rpm with Ees(RIGHT) = 0.3 mmHg/mL generated percentage changes up to 60% for left ventricular pressure–volume area and external work; up to 20% for left ventricular ESV and up to 25% for left ventricular EDV; up to 50% change in left atrial pressure-volume area (PVLA(L-A)) and only a 3% change in right atrial pressure–volume area (PVLA(R-A)). Percentage variation was lower when Ees(RIGHT) = 0.8 mmHg/mL. Early recognition of right ventricular failure followed by aggressive treatment is desirable, so as to achieve a more favourable outcome. RVAD support remains an option for advanced right ventricular failure, although the onset of major adverse events may preclude its use. |
format | Online Article Text |
id | pubmed-9137510 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-91375102022-05-28 Ventricular and Atrial Pressure—Volume Loops: Analysis of the Effects Induced by Right Centrifugal Pump Assistance De Lazzari, Beatrice Iacovoni, Attilio Capoccia, Massimo Papa, Silvia Badagliacca, Roberto Filomena, Domenico De Lazzari, Claudio Bioengineering (Basel) Article The main indications for right ventricular assist device (RVAD) support are right heart failure after implantation of a left ventricular assist device (LVAD) or early graft failure following heart transplantation. We sought to study the effects induced by different RVAD connections when right ventricular elastance (Ees(RIGHT)) was modified using numerical simulations based on atrial and ventricular pressure–volume analysis. We considered the effects induced by continuous-flow RVAD support on left/right ventricular/atrial loops when Ees(RIGHT) changed from 0.3 to 0.8 mmHg/mL during in-series or parallel pump connection. Pump rotational speed was also addressed. Parallel RVAD support at 4000 rpm with Ees(RIGHT) = 0.3 mmHg/mL generated percentage changes up to 60% for left ventricular pressure–volume area and external work; up to 20% for left ventricular ESV and up to 25% for left ventricular EDV; up to 50% change in left atrial pressure-volume area (PVLA(L-A)) and only a 3% change in right atrial pressure–volume area (PVLA(R-A)). Percentage variation was lower when Ees(RIGHT) = 0.8 mmHg/mL. Early recognition of right ventricular failure followed by aggressive treatment is desirable, so as to achieve a more favourable outcome. RVAD support remains an option for advanced right ventricular failure, although the onset of major adverse events may preclude its use. MDPI 2022-04-20 /pmc/articles/PMC9137510/ /pubmed/35621459 http://dx.doi.org/10.3390/bioengineering9050181 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article De Lazzari, Beatrice Iacovoni, Attilio Capoccia, Massimo Papa, Silvia Badagliacca, Roberto Filomena, Domenico De Lazzari, Claudio Ventricular and Atrial Pressure—Volume Loops: Analysis of the Effects Induced by Right Centrifugal Pump Assistance |
title | Ventricular and Atrial Pressure—Volume Loops: Analysis of the Effects Induced by Right Centrifugal Pump Assistance |
title_full | Ventricular and Atrial Pressure—Volume Loops: Analysis of the Effects Induced by Right Centrifugal Pump Assistance |
title_fullStr | Ventricular and Atrial Pressure—Volume Loops: Analysis of the Effects Induced by Right Centrifugal Pump Assistance |
title_full_unstemmed | Ventricular and Atrial Pressure—Volume Loops: Analysis of the Effects Induced by Right Centrifugal Pump Assistance |
title_short | Ventricular and Atrial Pressure—Volume Loops: Analysis of the Effects Induced by Right Centrifugal Pump Assistance |
title_sort | ventricular and atrial pressure—volume loops: analysis of the effects induced by right centrifugal pump assistance |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9137510/ https://www.ncbi.nlm.nih.gov/pubmed/35621459 http://dx.doi.org/10.3390/bioengineering9050181 |
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