The role of innovative modeling and imaging techniques in improving outcomes in patients with LVAD

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Mahwash Kassi¹  Katelyn E. Ingram²  Shannon I. Wilson³  Michael R. Moreno⁴  Albert Oh⁵ 

[1] Cardiology, DeBakey Heart and Vascular, Houston Methodist Hospital, Houston, TX, United States;DeBakey Heart and Vascular- Heart Center Research, Houston Methodist Research Institute, Houston, TX, United States;Department of Biomedical Engineering, Texas A&M University, College Station, TX, United States;J. Mike Walker ‘66 Department of Mechanical Engineering, Texas A&M University, College Station, TX, United States;School of Engineering Medicine, Texas A&M University, Houston, TX, United States;

关键词: LVAD;    imaging;    HRAEs;    hemodynamics;    outcomes;   

DOI  :  10.3389/fcvm.2023.1248300

 received in 2023-06-27, accepted in 2023-08-10,  发布年份 2023

来源: Frontiers

【 摘 要 】

Heart failure remains a significant cause of mortality in the United States and around the world. While organ transplantation is acknowledged as the gold standard treatment for end stage heart failure, supply is limited, and many patients are treated with left ventricular assist devices (LVADs). LVADs extend and improve patients' lives, but they are not without their own complications, particularly the hemocompatibility related adverse events (HRAE) including stroke, bleeding and pump thrombosis. Mainstream imaging techniques currently in use to assess appropriate device function and troubleshoot complications, such as echocardiography and cardiac computed tomography, provide some insight but do not provide a holistic understanding of pump induced flow alterations that leads to HRAEs. In contrast, there are technologies restricted to the benchtop—such as computational fluid dynamics and mock circulatory loops paired with methods like particle image velocimetry—that can assess flow metrics but have not been optimized for clinical care. In this review, we outline the potential role and current limitations of converging available technologies to produce novel imaging techniques, and the potential utility in evaluating hemodynamic flow to determine whether LVAD patients may be at higher risk of HRAEs. This addition to diagnostic and monitoring capabilities could improve prevention and treatment of LVAD-induced complications in heart failure patients.

【 授权许可】

Unknown   
© 2023 Wilson, Ingram, Oh, Moreno and Kassi.