Comparison of Hemodynamics in the Ascending Aorta Between Pulsatile and Continuous Flow Left Ventricular Assist Devices Using Computational Fluid Dynamics Based on Computed Tomography Images

2013 ◽  
Vol 38 (2) ◽  
pp. 142-148 ◽  
Author(s):  
Christof Karmonik ◽  
Sasan Partovi ◽  
Bastian Schmack ◽  
Alexander Weymann ◽  
Matthias Loebe ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Computed Tomography ◽  
Continuous Flow ◽  
Left Ventricular ◽  
Ascending Aorta ◽  
Ventricular Assist Devices ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Computed Tomography Images ◽  
Left Ventricular Assist

scholarly journals Echocardiography from a transhepatic approach in left ventricular assist device patients with difficult transthoracic imaging

2021 ◽  
Vol 5 (4) ◽  
Author(s):  
Mihai Strachinaru ◽  
Alexander Hirsch ◽  
Daniel Bowen ◽  
Kadir Caliskan
Keyword(s):  
Computed Tomography ◽  
Case Series ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Computed Tomography Images ◽  
Echocardiographic Image ◽  
Left Ventricular Assist

Abstract Background Left ventricular assist devices (LVADs) are increasingly used in the treatment of end-stage heart failure. One important limitation in the follow-up of these patients is the very difficult echocardiographic image, because of the interposition of implanted materials. Case summary  We present here a case series of LVAD patients with severely limited transthoracic echocardiographic windows in whom the echocardiographic analysis of the left and right ventricular function could be obtained from a very unusual approach, using a right intercostal transhepatic window, allowing visualization of the heart chambers and quantification of function even in these very challenging cases. In one case, the result was confirmed by computed tomography. In the second case, computed tomography images were unreliable because of strong artefacts from the LVAD system and implantable cardioverter-defibrillator leads, but the transhepatic approach still provided sufficient image quality in order to allow the imaging follow-up of the patient. In the third case, the transhepatic window was the only approach that provided echocardiographic images, and due to the good visualization of the heart cavities, this imaging technique was considered sufficient for follow-up studies in this stable subject with LVAD as destination therapy. Discussion  The transhepatic window may represent a good alternative in selected LVAD patients with very difficult acoustic access in traditional transthoracic views. Modified or alternate echocardiographic windows may reduce the need for invasive procedures (transoesophageal echocardiography) or imaging methods using radiations.

scholarly journals Endocrine Challenges in Patients with Continuous-Flow Left Ventricular Assist Devices

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 861
Author(s):  
Gennaro Martucci ◽  
Federico Pappalardo ◽  
Harikesh Subramanian ◽  
Giulia Ingoglia ◽  
Elena Conoscenti ◽  
...  
Keyword(s):  
Continuous Flow ◽  
Left Ventricular ◽  
Endocrine Function ◽  
Ventricular Assist Devices ◽  
Circulatory Support ◽  
Endocrine Dysfunction ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Assist Devices ◽  
Left Ventricular Assist

Heart failure (HF) remains a leading cause of morbidity, hospitalization, and mortality worldwide. Advancement of mechanical circulatory support technology has led to the use of continuous-flow left ventricular assist devices (LVADs), reducing hospitalizations, and improving quality of life and outcomes in advanced HF. Recent studies have highlighted how metabolic and endocrine dysfunction may be a consequence of, or associated with, HF, and may represent a novel (still neglected) therapeutic target in the treatment of HF. On the other hand, it is not clear whether LVAD support, may impact the outcome by also improving organ perfusion as well as improving the neuro-hormonal state of the patients, reducing the endocrine dysfunction. Moreover, endocrine function is likely a major determinant of human homeostasis, and is a key issue in the recovery from critical illness. Care of the endocrine function may contribute to improving cardiac contractility, immune function, as well as infection control, and rehabilitation during and after a LVAD placement. In this review, data on endocrine challenges in patients carrying an LVAD are gathered to highlight pathophysiological states relevant to this setting of patients, and to summarize the current therapeutic suggestions in the treatment of thyroid dysfunction, and vitamin D, erythropoietin and testosterone administration.

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