Journal of Cardiothoracic Surgery | |
Beneficial aspects of real time flow measurements for the management of acute right ventricular heart failure following continuous flow ventricular assist device implantation | |
Gero Tenderich1  Reiner Koerfer1  Dilek Guersoy1  Sotirios Spiliopoulos1  | |
[1] Department for the Surgical Management of End-stage Heart Failure and Mechanical Circulatory Support, Heart and Vascular Center Duisburg, Fahrner street 133-135, 47169, Duisburg, Germany | |
关键词: Ventricular assist devices; Right ventricle; Heart failure; | |
Others : 1152579 DOI : 10.1186/1749-8090-7-119 |
|
received in 2012-09-07, accepted in 2012-11-03, 发布年份 2012 | |
【 摘 要 】
Background
Optimal management of acute right heart failure following the implantation of a left ventricular assist device requires a reliable estimation of left ventricular preload and contractility. This is possible by real-time pump blood flow measurements.
Clinical case
We performed implantation of a continuous flow left ventricular assist device in a 66 years old female patient with an end-stage heart failure on the grounds of a dilated cardiomyopathy. Real-time pump blood flow was directly measured by an ultrasonic flow probe placed around the outflow graft.
Diagnosis
The progressive decline of real time flow and the loss of pulsatility were associated with an increase of central venous pressure, inotropic therapy and progressive renal failure suggesting the presence of an acute right heart failure. Diagnosis was validated by echocardiography and thermodilution measurements.
Treatment
Temporary mechanical circulatory support of the right ventricle was successfully performed. Real time flow measurement proved to be a useful tool for the diagnosis and ultimately for the management of right heart failure including the weaning from extracorporeal membrane oxygenation.
【 授权许可】
2012 Spiliopoulos et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150406192143798.pdf | 306KB | download |
【 参考文献 】
- [1]Dang NC, Topkara VK, Mercando M, et al.: Right heart failure after left ventricular assist device implantation in patients with chronic congestive heart failure. J Heart Lung Transplant 2006, 25(1):1-6.
- [2]Tsukiya T, Taenaka Y, Nishinaka T, et al.: Application of indirect flow measurements using motor driving signals to a centrifugal blood pump with an integrated motor. Artif Organs 2001, 25:692-696.
- [3]Thunberg CA, Gaitan BD, Arabia FA, et al.: Ventricular Assist devices today and tomorrow. J Cardiothorac Vasc Anaesth 2010, 24(3):656-680.
- [4]Noon GP, Loebe M: Current status of the MicroMed DeBakey Noon Ventricular Assist device. Tex Heart Inst J 2010, 37(6):652-663.
- [5]Benkowski R, Lynch B, Morello G, et al.: Real time flow measurement for a continuous flow VAD. ASAIO 2001, 47(2):133.