Pulmonary artery pulsatility index predicts prolonged inotrope/pulmonary vasodilator use after implantation of continuous flow left ventricular assist device

2019 ◽  
Vol 14 (6) ◽  
pp. 1130-1137
Author(s):  
Varun Aggarwal ◽  
Sebastian C. Tume ◽  
Marco Rodriguez ◽  
Iki Adachi ◽  
Antonio G. Cabrera ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Continuous Flow ◽  
Pulsatility Index ◽  
Left Ventricular ◽  
Assist Device ◽  
Ventricular Assist ◽  
Pulmonary Vasodilator ◽  
Left Ventricular Assist

Left ventricle assist device pulsatility index at the time of implantation is associated with follow-up pulmonary hemodynamics

2020 ◽  
Vol 43 (7) ◽  
pp. 452-460
Author(s):  
Jacob J Schaefer ◽  
Pavol Sajgalik ◽  
Sudhir S Kushwaha ◽  
Lyle J Olson ◽  
John M Stulak ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Pulsatility Index ◽  
Left Ventricular ◽  
Assist Device ◽  
Heartmate Ii ◽  
Ventricular Assist ◽  
Post Surgery ◽  
Left Ventricular Assist

HeartMate II left ventricular assist device controllers provide data including pulsatility index, reflecting the relationship between pump function and hemodynamics. We propose that a higher pulsatility index at hospital discharge following implant may be associated with less vascular congestion and improved clinical outcomes. A retrospective analysis of 40 patients (age 59.2 ± 10.3 years) supported with the HeartMate II devices was conducted. Data revealed moderate Pearson correlations between pulsatility index at discharge and right atrial pressure, pulmonary artery systolic pressure, pulmonary artery diastolic pressure, mean pulmonary arterial pressure, and pulmonary capillary wedge pressure, respectively, post-surgery (median of 377 days), demonstrating a stronger relationship when analyzed for the EPC controller (n = 28) only (r = −.57, p < .01; r = −.38, p < .05; r = −.59, p < .01; r = −.47, p = .01 and r = −.53, p < .01, respectively). The pulsatility index derived from the EPC controller was associated with the significant risk of re-hospitalization within 1 and 2 years after the implantation of left ventricular assist device; hazard ratio = 0.557 with 95% confidence interval (0.315–0.983), p = .04 and hazard ratio = .579 (0.341–0.984), p = .04. A higher pulsatility index at discharge was associated with greater volume unloading, lower pulmonary pressures, and lower risk of all-cause re-hospitalizations within 1 and 2 years post-surgery. As such, pump-derived data may provide additional value in predicting left ventricular assist device hemodynamics.

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