Role of B-Type Natriuretic Peptide and Effect of Nesiritide After Total Cardiac Replacement With the AbioCor Total Artificial Heart

Exercise blood pressure response during assisted circulatory support: Comparison of the total artifical heart with a left ventricular assist device during rehabilitation

“…We and others have observed that infusing synthetic brain natriuretic peptide (BNP) provides a renal protective effect after TAH implantation by replacing the abrupt loss of endogenous BNP. 12 In the 6 patients who received this intravenous vasodilator during treadmill exercise, we observed a clinically, but not statistically, significant decrease in systolic BP during exercise. There was, however, a statistically significant interaction observed between nesiritide administration and BP.…”

Evaluating Heart Failure After Implantation of Mechanical Circulatory Support Devices

“…This may be related to the sudden removal of the endogenous source B-type natriuretic peptide or inflammation and neurohormonal activation related to cardiopulmonary bypass and recovery from profound heart failure. We, and others, have observed that after ventriculectomy, low-dose nesiritide (0.005 μg/kg/min) can produce a dramatic increase in urine output and may be renally protective [23,24]. In fact, nesiritide is the primary mechanism for volume management in the perioperative period at our institution.…”

Impact of low-dose B-type natriuretic peptide infusion on urine output after total artificial heart implantation

“…Right heart failure (RHF) after left ventricular assist device (LVAD) implantation is a common problem in the immediate post-operative period and a significant cause of increased morbidity and death. 1 Worsening of right ventricular (RV) function after LVAD insertion has been attributed to changes in RV geometry and flow dynamics after left ventricular (LV) unloading. 2 The various factors contributing to this RV dysfunction are ameliorated in the postoperative period as RV/LV equilibrium is reached.…”

“…1,2 We hypothesized that infusion of exogenous BNP after ventriculectomy would improve renal function as marked by an increase in urine output.…”