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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...

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Autores principales: De Lazzari, Beatrice, Iacovoni, Attilio, Capoccia, Massimo, Papa, Silvia, Badagliacca, Roberto, Filomena, Domenico, De Lazzari, Claudio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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.
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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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