Device Management and Flow Optimization on Left Ventricular Assist Device Support

Inna Tchoukina; Melissa C Smallfield; Keyur B Shah

doi:10.1016/j.ccc.2018.03.002

Device Management and Flow Optimization on Left Ventricular Assist Device Support

Crit Care Clin. 2018 Jul;34(3):453-463. doi: 10.1016/j.ccc.2018.03.002.

Authors

Inna Tchoukina¹, Melissa C Smallfield², Keyur B Shah²

Affiliations

¹ Division of Cardiology, Department of Internal Medicine, Advanced Heart Failure and Transplantation, The Pauley Heart Center, Virginia Commonwealth University, 1200 East Broad Street, P.O. Box 980204, Richmond, VA 23298-0204, USA. Electronic address: [email protected].
² Division of Cardiology, Department of Internal Medicine, Advanced Heart Failure and Transplantation, The Pauley Heart Center, Virginia Commonwealth University, 1200 East Broad Street, P.O. Box 980204, Richmond, VA 23298-0204, USA.

PMID: 29907276
DOI: 10.1016/j.ccc.2018.03.002

Abstract

The authors discuss principles of continuous flow left ventricular assist device (LVAD) operation, basic differences between the axial and centrifugal flow designs and hemodynamic performance, normal LVAD physiology, and device interaction with the heart. Systematic interpretation of LVAD parameters and recognition of abnormal patterns of flow and pulsatility on the device interrogation are necessary for clinical assessment of the patient. Optimization of pump flow using LVAD parameters and echocardiographic and hemodynamics guidance are reviewed.

Keywords: Device parameters; Heart failure; Left ventricular assist device; Mechanical circulatory support; Pump thrombosis; Ramp study.

Publication types

Review

MeSH terms

Echocardiography
Heart Failure / physiopathology*
Heart Failure / therapy*
Heart Ventricles
Heart-Assist Devices* / adverse effects
Hemodynamics*
Humans
Ventricular Dysfunction, Left / physiopathology
Ventricular Dysfunction, Left / therapy*
Ventricular Dysfunction, Right / etiology