Reversibility of fixed pulmonary hypertension in left ventricular assist device support recipients

Mikus, Elisa; Stepanenko, Alexander; Krabatsch, Thomas; Loforte, Antonio; Dandel, Michael; Lehmkuhl, H.; Hetzer, Roland; Potapov, Evgenij

doi:10.1016/j.ejcts.2011.01.019

Cited by 109 publications

(108 citation statements)

References 24 publications

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“…1. The devices used are shown in 12) In contrast, group 3 patients did not show a statistically significant reduction in TPG and PVR during LVAD support, reflecting irreversible pulmonary hypertension. Consequently, prolonged support was required but with increased risk of complications and subsequently fatal outcome.…”

Section: Resultsmentioning

confidence: 99%

A UK Single Centre Retrospective Analysis of the Relationship between Haemodynamic Changes and Outcome in Patients Undergoing Prolonged Left Ventricular Assist Device Support

Capoccia

Bowles

Sabashnikov

et al. 2015

ATCS

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IntroductionAlthough heart transplantation remains the gold standard for the treatment of end-stage heart failure with an average 2-year survival rate of 80%, 1) its epidemiological impact is limited by organ availability. 2) Over the last 5 years, rotary left ventricular assist devices (LVADs) have been used increasingly either as a bridge to transplant or for permanent support. In spite of their clinical efficacy, LVADs remain associated with serious complications which compromise outcome. However, the association between changes in haemodynamic parameters during support and outcome remains inadequately Purpose: Despite their efficacy, LVADs remain associated with serious complications. The relationship between haemodynamic changes during support and outcome remains inadequately characterised. This association was investigated in LVAD recipients undergoing prolonged support. Methods: Forty patients receiving LVAD therapy for >2 years were reviewed retrospectively (mean support duration was 38.62 ± 15.28). Pre-and on-LVAD haemodynamic data were assessed in three groups: (1) those receiving ongoing support (n = 24); (2) those who underwent cardiac transplantation (n = 4); (3) those who died during support (n = 12). Results: For group 1 and 2, LVAD support achieved a decrease in mean PAP, mean PCWP, TPG, and PVR and an increase in thermodilution blood flow (TBF) with significance at ≤5% level. For group 3, there were non-significant changes in TPG and PVR at the 5% level but for mean PAP, mean PCWP, and TBF the changes were similar to Groups 1 and 2 with significance at ≤5% level. Aggregated data from all three groups showed a 58% increase in TBF on LVAD support. Conclusion: Highly significant and favourable haemodynamic changes were found. However, group 3 did not undergo decrease in TPG and PVR possibly because of suboptimal LVAD flow, right heart dysfunction and unavoidable prolongation of support.

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Section: Resultsmentioning

confidence: 99%

A UK Single Centre Retrospective Analysis of the Relationship between Haemodynamic Changes and Outcome in Patients Undergoing Prolonged Left Ventricular Assist Device Support

Capoccia

Bowles

Sabashnikov

et al. 2015

ATCS

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“…O segundo revelou efeito sustentado do sildenafil após quatro semanas de uso com redução da HP e melhora funcional 140 . Mais recentemente, o uso prolongado de assistência circulatória mecânica esquerda (seis meses) pode ser considerado como estratégia para redução da HP permitindo posteriormente o transplante 269,270 .…”

Section: Ic Direita E Hipertensão Pulmonar (Tabela 34)unclassified

Atualização da Diretriz Brasileira de Insuficiência Cardíaca Crônica - 2012

2012

Arquivos Brasileiros De Cardiologia

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“…[10][11][12][13] The reason for tolerance of ventricular fibrillation with LVAD support in these cases likely relates to the marked reduction in pulmonary vascular resistance, which is evident in patient with chronic LVAD support. 14,15 This allows for the creation of a Fontan-like circulation where even severely depressed or absent right ventricular function, which may occur in the setting of rapid ventricular tachycardia or ventricular fibrillation, can be tolerated without the development of cardiovascular collapse. 13 In this context, the second important finding reported in this article, that an active ICD does not confer an additional survival advantage after implantation of an LVAD, makes intuitive sense.…”

Section: Article See P 668mentioning

confidence: 99%

Role of Implantable Cardioverter-Defibrillators in Patients With Continuous Flow Ventricular Assist Devices

Boilson

Friedman

2013

Circ: Arrhythmia and Electrophysiology

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Reversibility of fixed pulmonary hypertension in left ventricular assist device support recipients

Abstract: Patients with fixed PH can be treated with LVAD support. Our data suggest that 6 months after LVAD implantation it is possible to observe an important reduction of PH and evaluate the potential transplantability of patients. Longer support does not add any effect of LVAD on PH.

Cited by 109 publications

References 24 publications

A UK Single Centre Retrospective Analysis of the Relationship between Haemodynamic Changes and Outcome in Patients Undergoing Prolonged Left Ventricular Assist Device Support

A UK Single Centre Retrospective Analysis of the Relationship between Haemodynamic Changes and Outcome in Patients Undergoing Prolonged Left Ventricular Assist Device Support

Atualização da Diretriz Brasileira de Insuficiência Cardíaca Crônica - 2012

Role of Implantable Cardioverter-Defibrillators in Patients With Continuous Flow Ventricular Assist Devices

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