Choroidal Microcirculation in Patients With Rotary Cardiac Assist Device

Polska, Elżbieta; Schima, Heinrich; Wieselthaler, Georg; Schmetterer, Leopold

doi:10.1016/j.healun.2007.03.004

Cited by 8 publications

(3 citation statements)

References 33 publications

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“…A study by Polska measured ocular choroid and ophthalmic artery blood flow at varying levels of CF‐LVAD support. The results of this study demonstrated that microcirculation is responsive to changes in continuous blood flow rates from the LVAD, and that it remains normal over a range of conditions 31 . In another study by den Uil, 32 a two‐dimensional microcirculation imaging device demonstrated that sublingual capillary flow was increased and maintained with three different CF‐LVADs in critically ill patients.…”

Section: Cf Lvads and End‐organ Functionmentioning

confidence: 57%

Long-Term Continuous Flow Left Ventricular Assist Device Support and End-Organ Function: Prospects for Destination Therapy

Slaughter

2010

Journal of Cardiac Surgery

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Pulsatile flow left ventricular assist devices (PF-LVADs) have successfully supported patients with severe heart failure for bridge-to-transplant (BTT) and destination therapy (DT). End-organ dysfunction is often reversed, optimizing the patient's condition to enhance survival, and quality of life. Questions have been raised regarding the potential for continuous flow LVADs (CF-LVADs) to provide the same quality of circulatory support. Prior research showing that PF is superior to continuous, non-PF does not appear to be relevant with CF-LVADs for BTT and DT. Under most clinical conditions, arterial pulsatility is present during CF-LVAD support, and this type of support should not be termed "nonpulsatile." Clinical studies have shown that renal, hepatic, and neurocognitive function is either maintained within a normal range, or is significantly improved, during CF-LVAD support for durations up to 15 months. Results of the randomized clinical trial between the CF HeartMate II and the pulsatile HeartMate XVE (both by Thoratec Corp, Pleasanton, CA, USA) are pending final US Food and Drug Administration (FDA) review and are not yet published. Studies of microcirculation during CF-LVAD support indicate that capillary blood flow is adequate to support cellular function. There are anecdotal cases of patients being supported with a CF-LVAD for over seven years with preserved end-organ function. Presently, there are no clinical reports indicating that end-organ function is not well maintained. Current clinical evidence indicates that end-organ perfusion and function can be well maintained for extended durations of support with a CF-LVAD.

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Section: Cf Lvads and End‐organ Functionmentioning

confidence: 57%

Long-Term Continuous Flow Left Ventricular Assist Device Support and End-Organ Function: Prospects for Destination Therapy

Slaughter

2010

Journal of Cardiac Surgery

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“…Data from single centers and the HeartMate II bridge-to-transplantation trial have consistently reported favorable effects on liver and kidney function [61][62][63][64]. In addition, stimulating investigations into endocrine function, ocular microcirculation, autoregulation of cerebral blood flow, and neurocognition have all found no untoward effects of continuous flow LVAD physiology [65][66][67][68]. In summary, current data suggest that intermediate term support with continuous flow LVAD physiology, other than the vascular system, maintains adequate end-organ function.…”

Section: Effect Of Continuous Flow Left Ventricular Assist Device Phymentioning

confidence: 99%

Creating adequate pulsatility with a continuous flow left ventricular assist device

Patel

Jorde

2016

Current Opinion in Cardiology

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“…Negative effects on microcirculation and neurocognitive functions have been excluded since the early days of long-term support [27][28][29].…”

Section: Cerebral Perfusionmentioning

confidence: 99%

Debate

Schima

Dimitrov²,

Zimpfer³

2016

Current Opinion in Cardiology

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Choroidal Microcirculation in Patients With Rotary Cardiac Assist Device

Cited by 8 publications

References 33 publications

Long-Term Continuous Flow Left Ventricular Assist Device Support and End-Organ Function: Prospects for Destination Therapy

Long-Term Continuous Flow Left Ventricular Assist Device Support and End-Organ Function: Prospects for Destination Therapy

Creating adequate pulsatility with a continuous flow left ventricular assist device

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