Focused Review on Transthoracic Echocardiographic Assessment of Patients with Continuous Axial Left Ventricular Assist Devices

Louis P. Perrault,Soon J. Park,Yan Topilsky,Jae K. Oh,Michel Carrier,Simon Maltais,Fawn W. Atchison

doi:10.4061/2011/187434

Louis P. Perrault, Soon J. Park + Show 5 more

Open Access

https://doi.org/10.4061/2011/187434

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Abstract

Left ventricular assist devices (LVADs) are systems for mechanical support for patients with end-stage heart failure. Preoperative, postoperative and comprehensive followup with transthoracic echocardiography has a major role in LVAD patient management. In this paper, we will present briefly the hemodynamics of axial-flow LVAD, the rationale, and available data for a complete and organized echocardiographic assessment in these patients including preoperative assessment, postoperative and long-term evaluation.

Highlights

Left ventricular assist devices (LVADs) are systems for mechanical support for patients with end-stage heart failure
Axial-flow pumps are connected in series to the left ventricle (LV) by the inflow cannula, with the LV being the direct source of preload essential for LVAD output
The volume of flow generated by continuous flow LVAD is determined by the speed of the rotation of the pump and by the differential pressure that exists across the device

Summary

Introduction

Left ventricular assist devices (LVADs) are systems for mechanical support for patients with end-stage heart failure. The Jarvik 2000 is an intraventricular axial flow pump that measures 25 mm in diameter by 55 mm in length with a weight of approximately 85 g It consists of the pump positioned inside the left ventricular cavity and the outflow cannula which can be anastomosed to the right anterior aspect of the ascending aorta or to the descending aorta. The HeartMate II LVAD (Thoratec, Pleasanton, CA) is a continuous, axial-flow LVAD, positioned in succession to the left ventricle (LV) It consists of a spinning rotor pump as its lone moving part, an inflow cannula, an outflow cannula, and a single driveline that exits percutaneously towards the electronic controller [6, 7]. An independent assessment of pump output using the TTE should be performed

Evaluation of Axial-Flow LVAD Hemodynamics

Postoperative Value of Echocardiography in LVAD Patients

Evaluation of Postoperative Hemodynamic Instability

Long-Term Echocardiographic Considerations in Patients with LVAD

Conclusion