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Cardiac Index Declines During Long‐Term Left Ventricular Device Support
Author(s) -
Kalathiya Rohan J.,
Houston Brian A.,
Chaisson Jordan M.,
Grimm Joshua C.,
Stevens Gerin R.,
Sciortino Christopher M.,
Shah Ashish S.,
Whitman Glenn J. R.,
Russell Stuart D.,
Tedford Ryan J.
Publication year - 2016
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/aor.12733
Subject(s) - preload , pulmonary wedge pressure , medicine , afterload , hemodynamics , cardiology , cardiac index , inotrope , ventricular assist device , heart failure , cardiac output
To investigate longitudinal trends in valvular and ventricular function with long‐term left ventricular assist device (LVAD) therapy, we analyzed hemodynamic and echocardiographic data of patients with at least 2 years of continuous LVAD support. All 130 patients who underwent HeartMate II implantation at our institution between 2005 and 2012 were reviewed. Twenty patients had hemodynamic and echocardiographic evaluations in both the early (0–6 months) and late (2–3 years) postoperative period. Patients on inotropic therapy or temporary mechanical support were excluded. The average times of early and late hemodynamic evaluations were 59 ± 41 days and 889 ± 160 days, respectively. Cardiac index (CI) declined by an average of 0.4 L/min/m 2 ( P = 0.04) with concomitant increase in pulmonary capillary wedge pressure (PCWP; P = 0.02). The right atrial pressure to PCWP (RAP:PCWP) ratio decreased during LVAD support suggesting improvement in right ventricular function. While there was an increase in degree of aortic insufficiency (AI) at the late follow‐up period ( P = 0.008), dichotomization by median decline in CI (−0.4 L/min/m 2 ) indicated no difference in prevalence of AI among the groups. CI declined in patients with HeartMate II after 2 years of continuous support. An increase in preload and afterload was observed in those with the greatest decline in CI.