Abstract
Results showing changes in hemodynamics associated with right ventricular failure in the presence of a left ventricular assist device (LVAD) are discussed. It was found that the central venous pressure (CVP) became greater than the pulmonary capillary wedge pressure (PCWP) with increasing pump speed. This is the first indication of right ventricular failure, which is accompanied by an increase in CVP/PCWP ratio. The analysis of changes in hemodynamics before and after LVAD implantation shows that CVP/PCWP ratio, CVP, PCWP, and right ventricular stroke work index (RVSWI) are especially sensitive to changes in right ventricular contractility. In addition, the CVP/PCWP ratio is a universal and significant predictor of right ventricular failure. Biventricular circulatory support was analyzed after connecting the right ventricle with decreased contractility to the pump. The allowable range of pump speed was determined to avoid suction effect. The LVAD pump speed should be 1.5-fold higher than the pump speed of the right ventricular assist device.
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