Dynamic computed tomography to determine cardiac output in patients with left ventricular assist devices Subha V. Raman, MD, MSEE, Tam Tran, BS, Orlando.

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Presentation transcript:

Dynamic computed tomography to determine cardiac output in patients with left ventricular assist devices Subha V. Raman, MD, MSEE, Tam Tran, BS, Orlando P. Simonetti, PhD, Benjamin Sun, MD The Journal of Thoracic and Cardiovascular Surgery Volume 137, Issue 5, Pages 1213-1217 (May 2009) DOI: 10.1016/j.jtcvs.2008.10.043 Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 A, Volume rendering of computed tomography (CT) images demonstrates the position of the outflow cannula and aorta in a patient with a left ventricular assist device. B, C, and D are axial CT images of the test bolus scan at serial time points after injection of contrast showing subsequent enhancement of the superior vena cava (SVC), main pulmonary artery (MPA), and ascending aorta (AAo). The average signal intensity within a region of interest placed in the AAo is 2, 24, and 128 Hounsfield units on these serial images. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 1213-1217DOI: (10.1016/j.jtcvs.2008.10.043) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 The average signal intensity in a region of interest drawn on the test bolus images in the distal ascending aorta versus time during injection of a small bolus of contrast. The blue dots represent the raw data, and the dotted pink line represents the gamma variate curve fit. HU, Hounsfield units. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 1213-1217DOI: (10.1016/j.jtcvs.2008.10.043) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 A, Linear regression between calculated cardiac output using the dynamic computed tomography technique and measured cardiac output using catheter thermodilution shows good agreement, with correlation coefficient of 0.74. B, Linear regression between the device cardiac output readout and thermodilution measurement shows poor agreement, with correlation coefficient of 0.14. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 1213-1217DOI: (10.1016/j.jtcvs.2008.10.043) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Bland-Altman plot shows the difference between the two cardiac output (CO) measurement techniques versus the average value obtained with the 2 techniques. The mean difference was 0.54 L/min, with a 95% confidence interval difference of 0.66 to 0.94 L/min. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 1213-1217DOI: (10.1016/j.jtcvs.2008.10.043) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions