Right ventricular performance and left ventricular assist device filling

William A. Mandarino, Stephen Winowich, John Gorcsan, Thomas A. Gasior, Si M. Pham, Bartley P. Griffith, Robert L. Kormos

Research output: Contribution to journalArticlepeer-review

Abstract

Background. Right ventricular (RV) function is believed to be an important determinant of left ventricular assist device (LVAD) filling. This study was designed to demonstrate this relation in patients. Methods. To demonstrate the interaction between RV ejection and LVAD filling, 10 patients (mean age, 49 ± 13 years) supported with an LVAD were studied. Right ventricular pressure-area loops from cross-sectional area using transesophageal echocardiographic automated border detection and high-fidelity RV pressure were recorded simultaneously with LVAD volume during intraoperative inferior vena cava occlusion. Beat-by-beat RV ejection phase indices were calculated: stroke area, peak ejection rate, and stroke work. The LVAD filling rate was calculated as the first derivative of the volume, and the peak filling rate and the mean filling rate during RV systole were determined for each cardiac cycle. Results. Right ventricular stroke area, peak ejection rate, and stroke work were closely correlated with LVAD peak filling rate (r = 0.87 ± 0.09, r = 0.83 ± 0.09, and r = 0.85 ± 0.10, respectively). Also, baseline LVAD mean filling rate correlated with RV stroke work (r = 0.77) and LVAD peak filling rate with RV peak ejection rate for the group (r = 0.75). Conclusions. These correlations demonstrate predictable associations of RV ejection with LVAD filling.

Original languageEnglish (US)
Pages (from-to)1044-1049
Number of pages6
JournalAnnals of Thoracic Surgery
Volume63
Issue number4
DOIs
StatePublished - Apr 1997

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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