Abstract
Background: The magnitude and time course whereby left ventricular assist devices (LVAD) decrease pulmonary artery (PA) pressures is not well understood. The purpose of this study was to describe longitudinal hemodynamic trends in LVAD patients previously implanted with a remote monitoring PA pressure sensor. Methods: We conducted a retrospective cohort study on 39 HeartMate-IITM LVAD patients who had previously been implanted with a CardioMEMS™ PA pressure sensor. De-identified PA pressure data transmitted to the Abbott Merlin.net™ patient care network were retrieved for patients who had made a transmission at-least 4 weeks prior to LVAD implantation (baseline pressure) and a transmission within 4 weeks following the implant. Trends in mean, diastolic, systolic and pulse PA pressures were analyzed over a 6 month time period post LVAD implant. The change relative to the baseline was assessed and a standard t-test with equal variance was utilized for statistical analysis. Results: The average age was 56.3 ± 11.0 years and 69% were male. The mean PA pressure at baseline was 40.7 ± 9.1 mmHg which decreased 27.0% to 29.7 ± 7.2 mmHg, P < .001 (median 29.7 mmHg) at one month post LVAD with reduction of 28.5% from baseline to 29.1 ± 6.9 mmHg by 6 months (P < .001). At baseline, the patients had high mean, systolic, diastolic and pulse PA pressures (see Figure), all of which reduced significantly over the first 3 months and stabilized thereafter Conclusion: Pulmonary artery pressures decrease significantly in the first month sustained at 6 months following LVAD implantation. PAP monitoring may aid in the clinical hemodynamic management of LVAD patients and may help in establishing transplant eligibility for those patients with pre-operative pulmonary hypertension.
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