| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
The Journal of Thoracic and Cardiovascular Surgery, Vol 99, 809-816, Copyright © 1990 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
JR Elbeery, CH Owen, MA Savitt, JW Davis, MP Feneley, JS Rankin and P VanTrigt
Right ventricular failure is a leading cause of death in patients who
require the left ventricular assist device. Previous reports suggested
right ventricular functional deterioration during left ventricular assist
but lacked a method by which right ventricular function could be quantified
adequately. This study examined the effects of left ventricular volume
unloading on right ventricular systolic function by means of the stroke
work/end-diastolic volume relationship, a load- insensitive index of
myocardial performance. In 12 anesthetized open- chested dogs, right
ventricular and left ventricular pressures were measured with
micromanometers while ultrasonic dimension transducers measured left and
right ventricular orthogonal diameters. Left ventricular unloading was
accomplished with left atrial-to-femoral artery bypass with a centrifugal
pump. Data were recorded during transient vena caval occlusion in the
control state and with maximal left ventricular unloading by full support
by the left ventricular assist device. Modified ellipsoidal geometry was
used to calculate simultaneous biventricular volumes, and linear regression
analysis of right ventricular stroke work versus end-diastolic volume was
used to quantify right ventricular systolic function. Average slope and x
intercept of this relationship under control conditions were 2.2 +/- 0.3 X
10(4) erg/ml and 10.7 +/- 5.0 ml, respectively. During full support by the
left ventricular assist device (mean flow rate, 2.4 +/- 0.3 L/min), left
ventricular end-diastolic volume decreased by 31% (p less than 0.01), left
ventricular septal-free wall diameter decreased by 7% (p less than 0.001),
and rate of rise of right ventricular peak positive pressure declined by
13% (p less than 0.05). The corresponding slope and x intercept of the
right ventricular stroke work/end- diastolic volume relationship during
full unloading of left ventricular assist device were 2.3 +/- 0.3 X 0.3 X
10(4) erg/ml and 14.3 +/- 4.8 ml, respectively; these values were not
significantly different from control values (p greater than 0.5).
Additionally, analysis of right ventricular end-diastolic pressure-volume
relationships suggested improved right ventricular chamber compliance,
although the effects were small and did not reach statistical significance
(p = 0.10). These data imply that marked alterations in biventricular
geometry accompanying left ventricular volume unloading by the left
ventricular assist device in a normal heart do not significantly alter
right ventricular performance characteristics.
ARTICLES
Effects of the left ventricular assist device on right ventricular function
Department of Surgery, Duke University Medical Center, Durham, N.C. 27710.
This article has been cited by other articles:
|
|
 |
|
  J. Mau, S. Menzie, Y. Huang, M. Ward, and S. Hunyor Chronic septal infarction confers right ventricular protection during mechanical left ventricular unloading J. Thorac. Cardiovasc. Surg., July 1, 2009; 138(1): 172 - 178. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. D. Patel, E. S. Weiss, J. Schaffer, S. L. Ullrich, D. C. Rivard, A. S. Shah, S. D. Russell, and J. V. Conte Right Heart Dysfunction After Left Ventricular Assist Device Implantation: A Comparison of the Pulsatile HeartMate I and Axial-Flow HeartMate II Devices Ann. Thorac. Surg., September 1, 2008; 86(3): 832 - 840. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Mau, S. Menzie, M. Ward, H. Bundgaard, and S. Hunyor Time-dependent response of both ventricles after septal ablation: Implications for biventricular support after left ventricular assist device placement J. Thorac. Cardiovasc. Surg., September 1, 2007; 134(3): 579 - 586. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. E. Stone Current Status of Mechanical Circulatory Assistance Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2007; 11(3): 185 - 204. [Abstract] [PDF]
|
|
|
|
 |
|
 E. Catena, F. Milazzo, M. Merli, R. Paino, A. Garatti, T. Colombo, and E. Vitali Echocardiographic evaluation of patients receiving a new left ventricular assist device: the Impella(R) recover 100 Eur J Echocardiogr, December 1, 2004; 5(6): 430 - 437. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. H. Van Meter Jr Right heart failure: best treated by avoidance Ann. Thorac. Surg., March 1, 2001; 71 (2007): S220 - S222. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. K. Karunanithi, J. Michniewicz, J. A. Young, and M. P. Feneley Effect of acutely increased left ventricular afterload on work output from the right ventricle in conscious dogs J. Thorac. Cardiovasc. Surg., January 1, 2001; 121(1): 0116 - 124. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. K. Karunanithi and M. P. Feneley Limitations of unidimensional indexes of right ventricular contractile function in conscious dogs J. Thorac. Cardiovasc. Surg., August 1, 2000; 120(2): 302 - 312. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J R Beck, L B Mongero, R M Kroslowitz, A F Choudhri, J M Chen, J J DeRose, M Argenziano, A J Smerling, and M C Oz Inhaled nitric oxide improves hemodynamics in patients with acute pulmonary hypertension after high-risk cardiac surgery Perfusion, January 1, 1999; 14(1): 37 - 42. [Abstract] [PDF]
|
|
|
|
|
|
M. Argenziano, A. F. Choudhri, N. Moazami, E. A. Rose, C. R. Smith, H. R. Levin, A. J. Smerling, and M. C. Oz Randomized, Double-Blind Trial of Inhaled Nitric Oxide in LVAD Recipients With Pulmonary Hypertension Ann. Thorac. Surg., February 1, 1998; 65(2): 340 - 345. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. R. Moon, A. F. Bolger, A. DeAnda, M. Komeda, G. T. Daughters II, S. D. Nikolic, D. C. Miller, and N. B. Ingels Septal Function During Left Ventricular Unloading Circulation, March 4, 1997; 95(5): 1320 - 1327. [Abstract] [Full Text]
|
|
|
|
|
|
A. C. Nicolosi, D. A. Hettrick, and D. C. Warltier Assessment of Right Ventricular Function in Swine Using Sonomicrometry and Conductance Ann. Thorac. Surg., May 1, 1996; 61(5): 1381 - 1387. [Abstract] [Full Text]
|
|
|
|
|
|
C.-H. Park, K. Nishimura, M. Kitano, K. Matsuda, Y. Okamoto, and T. Ban ANALYSIS OF RIGHT VENTRICULAR FUNCTION DURING BYPASS OF THE LEFT SIDE OF THE HEART BY AFTERLOAD ALTERATIONS IN BOTH NORMAL AND FAILING HEARTS J. Thorac. Cardiovasc. Surg., May 1, 1996; 111(5): 1092 - 1102. [Abstract] [Full Text]
|
|
|
|
|
|
A. Pavie and P. Leger Physiology of Univentricular Versus Biventricular Support Ann. Thorac. Surg., January 1, 1996; 61(1): 347 - 349. [Abstract] [Full Text]
|
|
|
|
|
|
W. P. Santamore and L. A. Gray Jr Left Ventricular Contributions to Right Ventricular Systolic Function During LVAD Support Ann. Thorac. Surg., January 1, 1996; 61(1): 350 - 356. [Abstract] [Full Text]
|
|
|
|
|
|
J. R Beck, L. B Mongero, D. J Goldstein, and M. C Oz Perfusion technique for treatment of right heart failure Perfusion, September 1, 1995; 10(5): 323 - 326. [Abstract] [PDF]
|
|
|
|
|
|
M. Kitano, K. Nishimura, P. C. Hee, Y. Okamoto, and T. Ban Right ventricular function evaluated by volumetric analysis during left heart bypass in a canine model of postischemic cardiac dysfunction J. Thorac. Cardiovasc. Surg., April 1, 1995; 109(4): 796 - 803. [Abstract] [Full Text]
|
|
|
|
|
|
K. Fujita, G. E. McGrath, T. Morita, B. L. Robinson, J. W. Davis, and J. J. Morris The effects of left heart assist on right ventricular muscle mechanics and ventricular coupling in the injured heart J. Thorac. Cardiovasc. Surg., September 1, 1994; 108(3): 477 - 486. [Abstract] [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
