HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Westaby, S. Articles by Frazier, O.H. Search for Related Content PubMed PubMed Citation Articles by Westaby, S. Articles by Frazier, O.H. Related Collections Great vessels Mechanical Circulatory Assistance

J Thorac Cardiovasc Surg 2007;133:575-576
© 2007 The American Association for Thoracic Surgery

Brief Communication

Circulatory support with attenuated pulse pressure alters human aortic wall morphology

^a Oxford Heart Center, John Radcliffe Hospital, Department of Cardiothoracic Surgery, Oxford, United Kingdom
^b The Texas Centre, Houston, Tex.

Received for publication October 5, 2006; accepted for publication October 9, 2006.

^_* Corresponding Author: Prof. Stephen Westaby, FRCS, MS, PhD, FETCS, FESC, FACC, FICA, Oxford Heart Center, John Radcliffe Hospital, Department of Cardiothoracic Surgery, Headley Way, Headington, Oxford, Oxfordshire Ox3 9DU, United Kingdom. (Email: swestaby@AHF.org.uk).

The first 20% of the full text of this article appears below.

In biology "form follows function." Hypertension causes the musculoelastic aortic wall to thicken.¹ The only situation characterized by chronic hypotension with diminished pulse pressure is in patients having long-term support with a left ventricular assist device (LVAD). In a sheep model of chronic nonpulsatile blood flow, the medial layer thinned with apoptosis of smooth muscle cells (SMCs) and fragmentation of elastic fibers.² We sought to determine the clinical implications of this finding for destination therapy patients with a rotary blood pump.

Clinical Summary

In 7 patients with end-stage heart failure, computed tomographic scans were taken before implantation of a Jarvik 2000 LVAD (Jarvik Heart, Inc, New York, NY) and then annually during survival. Preoperative and latest postoperative aortic diameters were compared. After 5 deaths at between 7 days and 34 months of support, we obtained multiple full-thickness sections of the descending thoracic aorta. At least two nonadjacent sections were processed for each patient. The samples were fixed and stained with hematoxylin and eosin (H&E) and elastic van Gieson (EVG) stains. Control . . . [Full Text of this Article]

This article has been cited by other articles:

				K. Toda, T. Fujita, K. Domae, Y. Shimahara, J. Kobayashi, and T. Nakatani Late Aortic Insufficiency Related to Poor Prognosis During Left Ventricular Assist Device Support Ann. Thorac. Surg., September 1, 2011; 92(3): 929 - 934. [Abstract] [Full Text] [PDF]

				K. N. Hong, A. Iribarne, J. Yang, B. Ramlawi, H. Takayama, Y. Naka, and M. J. Russo Do Posttransplant Outcomes Differ in Heart Transplant Recipients Bridged With Continuous and Pulsatile Flow Left Ventricular Assist Devices? Ann. Thorac. Surg., June 1, 2011; 91(6): 1899 - 1906. [Abstract] [Full Text] [PDF]

				J. Cowger, F. D. Pagani, J. W. Haft, M. A. Romano, K. D. Aaronson, and T. J. Kolias The Development of Aortic Insufficiency in Left Ventricular Assist Device-Supported Patients Circ Heart Fail, November 1, 2010; 3(6): 668 - 674. [Abstract] [Full Text] [PDF]

				A. S. Stewart, M. J. Russo, T. P. Martens, T. M. Naseem, M. C. Deng, R. Wang, M. Argenziano, M. Oz, and Y. Naka Longer duration of continuous-flow ventricular assist device support predicts greater hemodynamic compromise after return of pulsatility. J. Thorac. Cardiovasc. Surg., August 1, 2008; 136(2): 524 - 525. [Full Text] [PDF]