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Preload Sensitivity in Cardiac Assist Devices

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Presentation on theme: "Preload Sensitivity in Cardiac Assist Devices"— Presentation transcript:

1 Preload Sensitivity in Cardiac Assist Devices
Kiyotaka Fukamachi, MD, PhD, Akira Shiose, MD, PhD, Alex Massiello, MEBME, David J. Horvath, MSME, Leonard A.R. Golding, MB, BS, Sangjin Lee, MD, Randall C. Starling, MD, MPH  The Annals of Thoracic Surgery  Volume 95, Issue 1, Pages (January 2013) DOI: /j.athoracsur Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Typical left ventricular pressure-volume loops during inferior vena cava occlusion obtained from a healthy canine in an open-chest condition. As preload decreases, stroke volume decreases proportionally as the decrease in end-diastolic volume exceeds the decrease in end-systolic volume. There is a 20% decrease in stroke volume from 30 mL (blue loop) to 25 mL (red loop) with decreasing preload. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 (A) Schematic drawing and (B) photography of the total artificial heart mock circulatory loop. (CFTAH = continuous-flow total artificial heart.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Comparison of preload sensitivity of continuous-flow devices (yellow bars) and pulsatile-flow devices (blue bars) with that of human left ventricle (green bars). (CFTAH = continuous-flow total artificial heart; LV = left ventricle; LVAD = left ventricular assist device; TAH = total artificial heart.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Preload sensitivity relationships for the devices evaluated in our mock circulatory loops and that obtained for the human left ventricle. (CFLVAD = continuous-flow left ventricular assist device; CFTAH = continuous-flow total artificial heart; HF = heart failure; HM = HeartMate; LV = left ventricle; PFLVAD = pulsatile-flow left ventricular assist device; PFTAH = pulsatile-flow total artificial heart.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

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