Continuous-Flow Left Ventricular Assist Device and the Right Ventricle

Puhlman, Mark

doi:10.1097/nci.0b013e31823ef240

Cited by 10 publications

(7 citation statements)

References 14 publications

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“…In patients with LVAD, if oxygen saturation does not respond to the above measures, a possibility of right ventricular dysfunction must be considered. [20] Use of milrinone is recommended in such patients to augment right heart output. [12,21] Milrinone by its inotropic properties in such patients not only augments the native left ventricular output, but also improves right ventricular function and thus mitigates a possible failure of right heart.…”

Section: Discussionmentioning

confidence: 99%

Anesthesia for gastrointestinal endoscopy in patients with left ventricular assist devices: Initial experience with 68 procedures

Goudra¹,

Singh²

2013

Ann Card Anaesth

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Section: Discussionmentioning

confidence: 99%

Anesthesia for gastrointestinal endoscopy in patients with left ventricular assist devices: Initial experience with 68 procedures

Goudra¹,

Singh²

2013

Ann Card Anaesth

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“…A serious complication after prolonged LVAD support is right-sided HF [81, 82]. A recent post-market evaluation study showed right HF to occur in 9 % of patients, representing 0.10 events per patient-year [83].…”

Section: Renal Function In the Long Runmentioning

confidence: 99%

“…Increased filling pressure may cause RV overdistension and decrease myocardial perfusion, leading to RV failure. This, in turn, results in venous congestion in the kidneys (and other organs) [82], reducing perfusion and eGFR [27]. …”

Section: Renal Function In the Long Runmentioning

confidence: 99%

Left ventricular assist devices: a kidney’s perspective

2015

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The left ventricular assist device (LVAD) has become an established treatment option for patients with refractory heart failure. Many of these patients experience chronic kidney disease (CKD) due to chronic cardiorenal syndrome type II, which is often alleviated quickly following LVAD implantation. Nevertheless, reversibility of CKD remains difficult to predict. Interestingly, initial recovery of GFR appears to be transient, being followed by gradual but significant late decline. Nevertheless, GFR often remains elevated compared to preimplant status. Larger GFR increases are followed by a proportionally larger late decline. Several explanations for this gradual decline in renal function after LVAD therapy have been proposed, yet a definitive answer remains elusive. Mortality predictors of LVAD implantation are the occurrence of either postimplantation acute kidney injury (AKI) or preimplant CKD. However, patient outcomes continue to improve as LVAD therapy becomes more widespread, and adverse events including AKI appear to decline. In light of a growing destination therapy population, it is important to understand the cumulative effects of long-term LVAD support on kidney function. Additional research and passage of time are required to further unravel the intricate relationships between the LVAD and the kidney.

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“…It is often accomplished at a minimum of 90 beats per minute. 57 When using pharmaceuticals to maintain sinus rhythm, associated negative inotropic and systemic vasodilatory side effects should be kept in mind.…”

Section: Preoperative Consultation and Premedicationmentioning

confidence: 99%

A pathophysiological approach towards right ventricular function and failure

Vandenheuvel

Bouchez

Wouters

et al. 2013

European Journal of Anaesthesiology

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The scope of this review is to provide a pathophysiological summary of perioperative right ventricular function and failure. In recent decades, the importance of right ventricular function in the perioperative period has been established. However, much of our current knowledge on the management of this clinical entity is based on extrapolation of results from left ventricular research, although biventricular physiology is known to be markedly different in many aspects. Here, on the basis of a thorough literature search, we review theoretical as well as practical aspects of perioperative right ventricular failure. After underlining the importance of this topic, we review basic right ventricular anatomy and physiology, with an emphasis on the role of ventricular interaction. Next, potential causes of perioperative right ventricular failure are discussed. The emphasis of this review is on the perioperative anaesthetic considerations, ranging from preoperative assessment through intraoperative monitoring to specific contemporary therapeutic options of perioperative right ventricular failure.

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Continuous-Flow Left Ventricular Assist Device and the Right Ventricle

Cited by 10 publications

References 14 publications

Anesthesia for gastrointestinal endoscopy in patients with left ventricular assist devices: Initial experience with 68 procedures

Anesthesia for gastrointestinal endoscopy in patients with left ventricular assist devices: Initial experience with 68 procedures

Left ventricular assist devices: a kidney’s perspective

A pathophysiological approach towards right ventricular function and failure

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