Faculty Collaboration Database

Effects of the HeartMate II left ventricular assist device as observed by serial echocardiography. Echocardiography 2013 May;30(5):513-20

Date

01/15/2013

Pubmed ID

23311405

Pubmed Central ID

PMC4224296

DOI

10.1111/echo.12100

Scopus ID

2-s2.0-84876100776 (requires institutional sign-in at Scopus site)   18 Citations

Abstract

BACKGROUND: The HeartMate II is the most frequently used left ventricular assist device (LVAD) in patients with end-stage heart failure. There is a paucity of data regarding its longitudinal cardiac effects, particularly that on diastole.

METHODS: This retrospective study was an evaluation of echocardiograms preoperatively and at 3, 6, and 12 months postoperatively in patients with a HeartMate II. Measurements included left ventricle (LV) dimensions, ejection fraction (EF), right ventricle (RV) size and function, parameters of diastolic function, and an analysis of mitral regurgitation (MR), tricuspid regurgitation (TR), aortic insufficiency (AI), and aortic valve thickening.

RESULTS: Forty-seven patients were evaluated. LV dimensions decreased but EF, RV size, and RV function were unchanged. Right ventricular systolic pressure (RVSP) and diastolic parameters including mitral inflow E/A, deceleration time (DT), pulmonary vein inflow, left atrial size, and overall diastolic grade improved. LV relaxation measured by tissue Doppler (e') was unchanged and the E/e' ratio was also unchanged. Regarding valve function, MR decreased, TR was unchanged, and the aortic valve became increasingly thickened with increased AI severity.

CONCLUSIONS: The HeartMate II unloads the LV as shown by decreased LV size, decreased MR, reduced RVSP, and improved patterns of mitral inflow. However, neither systolic function nor diastolic relaxation improves in this cohort. RV size and function also remain unchanged. The aortic valve shows increased thickening and AI likely from valve leaflet fusion. These results provide detailed functional and hemodynamic information regarding the longitudinal effects of the HeartMate II.

Author List

Chapman CB, Allana S, Sweitzer NK, Kohmoto T, Murray M, Murray D, Johnson M, Rahko PS

Author

Takushi Kohmoto MD, PhD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Cohort Studies
Echocardiography, Doppler
Female
Follow-Up Studies
Heart Failure
Heart Function Tests
Heart-Assist Devices
Hemodynamics
Humans
Male
Middle Aged
Monitoring, Physiologic
Postoperative Care
Postoperative Complications
Preoperative Care
Retrospective Studies
Risk Assessment
Stroke Volume
Survival Rate
Treatment Outcome
Ventricular Function, Left
Ventricular Function, Right