Renal Function After Implantation of Continuous Versus Pulsatile Flow Left Ventricular Assist Devices

Sandner, Sigrid; Zimpfer, Daniel; Zrunek, Philipp; Dunkler, Daniela; Schima, Heinrich; Rajek, Angela; Grimm, Michael; Wolner, Ernst; Wieselthaler, Georg

doi:10.1016/j.healun.2007.12.012

Cited by 78 publications

(62 citation statements)

References 27 publications

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“…More recent studies using continuous-flow devices appear to be associated with a lower incidence (range, 7%-14%) of postimplantation AKI (Table 1) (20,21,29,47,57,58). Although several variables could be responsible for this reduction in AKI, it is unlikely that the choice of LVAD is critical because Sandner et al reported a similar incidence of AKI with both pulsatile and continuous devices (44). Instead, it is more likely that the reduction in postoperative AKI is due to the trend to implant patients who are more hemodynamically stable (47).…”

Section: Aki and Lvadmentioning

confidence: 97%

“…Most of these studies demonstrate either stable to improved renal function after implantation of continuousflow LVADs for periods up to 3.7 years (11,19,(42)(43)(44)(45)(46). In contrast, Hasin et al reported on 83 patients who received a continuous-flow LVAD as either BTT or DT (47).…”

Section: Continuous Blood Flow and Renal Functionmentioning

confidence: 99%

“…The incidence of AKI after LVAD implantation has been reported to range from 7% to 56% (Table 1) (20,21,23,26,29,44,47,(49)(50)(51)(52)(53)(54)(55)(56)(57)(58). There are multiple reasons for the large variation in AKI incidence, which include varying definitions for AKI, the time period during which the study was performed, the baseline severity of heart failure (INTERMACS level), and the incidence and severity of pre-existing RD.…”

Section: Aki and Lvadmentioning

confidence: 99%

“…Mortality associated with postimplantation AKI is very high, ranging from 57% to 93% in initial studies (Table 1) (23,26,44,49,53,56). For example, Sandner et al reported in a population of continuous-flow LVAD recipients that survival rates at 1, 3, and 6 months post-LVAD implantation were 83% (25 of 30), 49% (14 of 29), and 29% (5 of 17), respectively, for patients who required postoperative CRRT versus 96% (54 of 56), 87% (41 of 47), and 78% (20 of 26) for patients who did not require postoperative CRRT (23).…”

Section: Aki and Lvadmentioning

confidence: 99%

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Renal Failure in Patients with Left Ventricular Assist Devices

Patel

Adeseun

Ahmed

et al. 2013

Clinical Journal of the American Society of Nephrology

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SummaryImplantable left ventricular assist devices (LVADs) are increasingly being used as a bridge to transplantation or as destination therapy in patients with end stage heart failure refractory to conventional medical therapy. A significant number of these patients have associated renal dysfunction before LVAD implantation, which may improve after LVAD placement due to enhanced perfusion. Other patients develop AKI after implantation. LVAD recipients who develop AKI requiring renal replacement therapy in the hospital or who ultimately require longterm outpatient hemodialysis therapy present management challenges with respect to hemodynamics, volume, and dialysis access. This review discusses the mechanics of a continuous-flow LVAD (the HeartMate II), the effects of continuous blood flow on the kidney, renal outcomes of patients after LVAD implantation, dialysis modality selection, vascular access, hemodynamic monitoring during the dialytic procedure, and other issues relevant to caring for these patients.

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Section: Aki and Lvadmentioning

confidence: 97%

Section: Continuous Blood Flow and Renal Functionmentioning

confidence: 99%

Section: Aki and Lvadmentioning

confidence: 99%

Section: Aki and Lvadmentioning

confidence: 99%

See 2 more Smart Citations

Renal Failure in Patients with Left Ventricular Assist Devices

Patel

Adeseun

Ahmed

et al. 2013

Clinical Journal of the American Society of Nephrology

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“…Despite early concerns regarding non-pulsatile flow, non-pulsatile LVADs have shown to improve end-organ function in patients with advanced heart failure (14)(15)(16)(17). Moreover, renal function improvement after LVAD implantation is associated with improved survival (16). Recently a new, less invasive left ventricular assist device became available for the treatment of chronic heart failure (18).…”

Section: Introductionmentioning

confidence: 99%

Evolution of Renal Function after Partial and Full Mechanical Support for Chronic Heart Failure

et al. 2014

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Purpose Recently a minimal invasive, partial support continuous flow left ventricular assist device (LVAD) became available for treatment of chronic heart failure. The aim of this study was to analyze whether partial support is capable of improving kidney function in end-stage heart failure. Methods We performed a single-center retrospective analysis of patients how received a full (n = 43) or partial support LVAD (n = 18) between 2007 and 2013. Patients on dialysis or in INTERMACS class I were excluded. Renal function was assessed until 3 months after the implantation. A calculated GFR less than 60 m/min was considered to be renal failure. Results Creatinine level after LVAD implant decreased 23% in patients on full support (1.3 ± 0.4 mg/dl vs. 1.0 ± 0.3 mg/dl; p<0.001) and 24% in patients on partial support (1.6 ± 0.6 mg/dl vs. 1.2 ± 0.4 mg/dl; p = 0.17) within 3 months. In each group patients with a pre-operative GFR less than 60 ml/min were selected. In this subgroup there was a 35% decrease in creatinine levels for patients on full support (1.7 ± 0.4 mg/dl vs. 1.1 ± 0.5 mg/dl; p<0.01) and a 32% decrease in patients on partial support (2 ± 0.4 mg/dl vs. 1.4 ± 0.3 mg/dl; p<0.05) at 3 months. Conclusions We observed a significant improvement in renal function in patients supported by full or partial support devices, even if the pre-operative renal function was severly impaired. The use of diuretics decreased in both groups. In chronic heart failure patients with impaired renal function, partial support is sufficient to improve renal function significantly.

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Renal Dysfunction inMCSPatients: Perioperative and Long‐Term Considerations

Vedage,

Brisco‐Bacik

2023

Textbook of Transplantation and Mechanical Support for End‐Stage Heart and Lung Disease

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Renal Function After Implantation of Continuous Versus Pulsatile Flow Left Ventricular Assist Devices

Cited by 78 publications

References 27 publications

Renal Failure in Patients with Left Ventricular Assist Devices

Renal Failure in Patients with Left Ventricular Assist Devices

Evolution of Renal Function after Partial and Full Mechanical Support for Chronic Heart Failure

Renal Dysfunction inMCSPatients: Perioperative and Long‐Term Considerations

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