Continuous Cardiac Output and Left Atrial Pressure Monitoring by Pulmonary Artery Pressure Waveform Analysis

2006 ◽  
Author(s):  
Zhenwei Lu ◽  
Ramakrishna Mukkamala
Keyword(s):  
Cardiac Output ◽  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Left Atrial ◽  
Atrial Pressure ◽  
Continuous Cardiac Output ◽  
Left Atrial Pressure ◽  
Waveform Analysis ◽  
Pressure Waveform ◽  
Pressure Monitoring

scholarly journals Continuous cardiac output and left atrial pressure monitoring by long time interval analysis of the pulmonary artery pressure waveform: proof of concept in dogs

2009 ◽  
Vol 106 (2) ◽  
pp. 651-661 ◽  
Author(s):  
Da Xu ◽  
N. Bari Olivier ◽  
Ramakrishna Mukkamala
Keyword(s):  
Cardiac Output ◽  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Exponential Decay ◽  
Left Atrial ◽  
Atrial Pressure ◽  
Left Atrial Pressure ◽  
Inertial Effects ◽  
Wave Reflections ◽  
Equilibrium Pressure

We developed a technique to continuously (i.e., automatically) monitor cardiac output (CO) and left atrial pressure (LAP) by mathematical analysis of the pulmonary artery pressure (PAP) waveform. The technique is unique to the few previous related techniques in that it jointly estimates the two hemodynamic variables and analyzes the PAP waveform over time scales greater than a cardiac cycle wherein wave reflections and inertial effects cease to be major factors. First, a 6-min PAP waveform segment is analyzed so as to determine the pure exponential decay and equilibrium pressure that would eventually result if cardiac activity suddenly ceased (i.e., after the confounding wave reflections and inertial effects vanish). Then, the time constant of this exponential decay is computed and assumed to be proportional to the average pulmonary arterial resistance according to a Windkessel model, while the equilibrium pressure is regarded as average LAP. Finally, average proportional CO is determined similar to invoking Ohm's law and readily calibrated with one thermodilution measurement. To evaluate the technique, we performed experiments in five dogs in which the PAP waveform and accurate, but highly invasive, aortic flow probe CO and LAP catheter measurements were simultaneously recorded during common hemodynamic interventions. Our results showed overall calibrated CO and absolute LAP root-mean-squared errors of 15.2% and 1.7 mmHg, respectively. For comparison, the root-mean-squared error of classic end-diastolic PAP estimates of LAP was 4.7 mmHg. On future successful human testing, the technique may potentially be employed for continuous hemodynamic monitoring in critically ill patients with pulmonary artery catheters.

scholarly journals Per-operative Changes of Pulmonary Artery Pressure following Closed Mitral Commissurotomy

2019 ◽  
Vol 11 (2) ◽  
pp. 147-151
Author(s):  
Muhammed Abdul Quaium Chowdhury ◽  
Mohammad Fazle Maruf ◽  
Minhazur Rahman ◽  
Subir Barua ◽  
Mamunur Rahman ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Mitral Stenosis ◽  
Left Atrial ◽  
Atrial Pressure ◽  
Left Atrial Pressure ◽  
Artery Pressure ◽  
Mitral Commissurotomy ◽  
Closed Mitral Commissurotomy

Background: Mitral stenosis is often present with pulmonary hypertension. Closed Mitral Commissurotomy (CMC) is a treatment of choice for severe mitral stenosis. In this study, we examined the per-operative changes of pulmonary artery pressure following opening of stenosed mitral valve. Methods: All these CMCs were performed routinely through the left antero-lateral thoracotomy (4th intercostal space) and dilatation was done by metallic Tubb’s Dilator. Peroperative left atrial and Pulminary Arterial pressures were measured before and after dilatation. Results: 15 patients had undergone CMC. Following CMC, per-operative mean Pulmonary artery pressure was reduced from 45.5±7.1 mm of Hg to 39.0±8.8 mm of Hg (p=0.043). Mean left atrial pressure reduced from 35.9±5.6 mm of Hg to 30.0±9.1 mm of Hg (p = 0.049). At three months follow up after closed mitral commissurotomy mitral valve area at echocardiography was found 2.29±0.18 cm2. There was no case of death after closed mitral commissurotomy. Mild mitral regurgitation occurred in 1 patient. Conclusion: We conclude that there is immediate significant reduction of pulmonary Artery pressure following closed mitral commissurotomy. This reduction is apparently comparable with a similar reduction of left atrial pressure. Cardiovasc. j. 2019; 11(2): 147-151

Development of a circulatory mock loop for biventricular device testing with various heart conditions

2020 ◽  
Vol 43 (9) ◽  
pp. 600-605 ◽  
Author(s):  
Yuichiro Kado ◽  
Takuma Miyamoto ◽  
David J Horvath ◽  
Shengqiang Gao ◽  
Kiyotaka Fukamachi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Left Atrial ◽  
Aortic Pressure ◽  
Atrial Pressure ◽  
Left Atrial Pressure ◽  
Right Atrial ◽  
Right Atrial Pressure ◽  
Artery Pressure

This study aimed to evaluate a newly designed circulatory mock loop intended to model cardiac and circulatory hemodynamics for mechanical circulatory support device testing. The mock loop was built with dedicated ports suitable for attaching assist devices in various configurations. This biventricular mock loop uses two pneumatic pumps (Abiomed AB5000™, Danvers, MA, USA) driven by a dual-output driver (Thoratec Model 2600, Pleasanton, CA, USA). The drive pressures can be individually modified to simulate a healthy heart and left and/or right heart failure conditions, and variable compliance and fluid volume allow for additional customization. The loop output for a healthy heart was tested at 4.2 L/min with left and right atrial pressures of 1 and 5 mm Hg, respectively; a mean aortic pressure of 93 mm Hg; and pulmonary artery pressure of 17 mm Hg. Under conditions of left heart failure, these values were reduced to 2.1 L/min output, left atrial pressure = 28 mm Hg, right atrial pressure = 3 mm Hg, aortic pressure = 58 mm Hg, and pulmonary artery pressure = 35 mm Hg. Right heart failure resulted in the reverse balance: left atrial pressure = 0 mm Hg, right atrial pressure = 30 mm Hg, aortic pressure = 100 mm Hg, and pulmonary artery pressure = 13 mm Hg with a flow of 3.9 L/min. For biventricular heart failure, flow was decreased to 1.6 L/min, left atrial pressure = 13 mm Hg, right atrial pressure = 13 mm Hg, aortic pressure = 52 mm Hg, and pulmonary artery pressure = 18 mm Hg. This mock loop could become a reliable bench tool to simulate a range of heart failure conditions.

scholarly journals Continuous Left Atrial Pressure Monitoring During MitraClip

2015 ◽  
Vol 8 (7) ◽  
pp. e117-e119 ◽  
Author(s):  
Mackram F. Eleid ◽  
Saurabh Sanon ◽  
Guy S. Reeder ◽  
Rakesh M. Suri ◽  
Charanjit S. Rihal
Keyword(s):  
Left Atrial ◽  
Atrial Pressure ◽  
Left Atrial Pressure ◽  
Pressure Monitoring
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