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Preoperative anatomical landmarks and longitudinal HeartMate 3 pump position in X-rays: Relevance for adverse events.
Artif Organs
December 2024
Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
Background: Left ventricular assist device (LVAD) malposition has been linked to hemocompatibility-related adverse events (HRAEs). This study aimed to identify preoperative anatomical landmarks and postoperative pump position, associated with HRAEs during LVAD support.
Methods: Pre- and postoperative chest X-ray measures (≤14 days pre-implantation, first postoperative standing, 6, 12, 18, and 24 months post-implantation) were analyzed for their association with HRAEs over 24 months in 33 HeartMate 3 (HM3) patients (15.
The control of left ventricular assist devices (LVADs) requires sensors and/or estimators to account for the physiological state of the patient and apply advanced controllers. Sensor characteristics are a challenge when using implantable pressure sensors because they influence the quality of physiological control and the robustness of the controlled system. The objective of this work is to investigate the performance and robustness of LVAD controllers that operate based on LVAD integrated pressure sensors.
View Article and Find Full Text PDFIn Vitro and In Silico Characterization of the Aggregation of Thrombi on Textured Ventricular Cannula.
Ann Biomed Eng
August 2024
Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, 14853, USA.
The unacceptably high stroke rate associated with HeartMate 3 ventricular assist device (VAD) without signs of adherent pump thrombosis is hypothesized to be the result of the emboli produced by the inflow cannula, that are ingested and ejected from the pump. This in vitro and numerical study aimed to emulate the surface features and supraphysiological shear of a ventricular cannula to provide insight into their effect on thrombogenesis. Human whole blood was perfused at calibrated flow rates in a microfluidic channel to achieve shear rates 1000-7500 s, comparable to that experienced on the cannula.
View Article and Find Full Text PDFA Computational Investigation of the Effects of Temporal Synchronization of Left Ventricular Assist Device Speed Modulation with the Cardiac Cycle on Intraventricular Hemodynamics.
Ann Biomed Eng
June 2024
Department of Mechanical Engineering, University of Washington, Seattle, WA, USA.
Article Synopsis
- Patients with advanced heart failure may receive a left ventricular assist device (LVAD) to help manage their condition, but the risk of stroke is still a concern due to changes in blood flow dynamics once the device is implanted.
- A study examined how the timing of a new pulsatility mode in the HeartMate 3 LVAD, which alters pump speed every two seconds, affects blood flow patterns that may contribute to blood clots.
- Findings suggested that aligning the pulsatility mode with the heart's peak pumping phase reduces stagnant blood areas, potentially lowering the risk of thrombus formation and improving patient outcomes.
Emergent decommissioning of HeartMate 3 for life-threatening hemorrhage.
J Vasc Surg Cases Innov Tech
April 2024
Section of Cardiothoracic Surgery, Department of Surgery, Ochsner Health, New Orleans, LA.
Left ventricular assist devices are known for the treatment of heart failure. We present a patient who underwent emergent decommissioning of his left ventricular assist device after experiencing life-threatening hemorrhage. In this case, the patient's outflow graft was avulsed from his left subclavian artery.
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