The main indications for right ventricular assist device (RVAD) support are right heart failure after implantation of a left ventricular assist device (LVAD) or early graft failure following heart transplantation. We sought to study the effects induced by different RVAD connections when right ventricular elastance (Ees(RIGHT)) was modified using numerical simulations based on atrial and ventricular pressure-volume analysis. We considered the effects induced by continuous-flow RVAD support on left/right ventricular/atrial loops when Ees(RIGHT) changed from 0.3 to 0.8 mmHg/mL during in-series or parallel pump connection. Pump rotational speed was also addressed. Parallel RVAD support at 4000 rpm with Ees(RIGHT) = 0.3 mmHg/mL generated percentage changes up to 60% for left ventricular pressure-volume area and external work; up to 20% for left ventricular ESV and up to 25% for left ventricular EDV; up to 50% change in left atrial pressure-volume area (PVLA(L-A)) and only a 3% change in right atrial pressure-volume area (PVLA(R-A)). Percentage variation was lower when Ees(RIGHT) = 0.8 mmHg/mL. Early recognition of right ventricular failure followed by aggressive treatment is desirable, so as to achieve a more favourable outcome. RVAD support remains an option for advanced right ventricular failure, although the onset of major adverse events may preclude its use.

Ventricular and atrial pressure-volume loops. analysis of the effects induced by right centrifugal pump assistance / De Lazzari, Beatrice; Iacovoni, Attilio; Capoccia, Massimo; Papa, Silvia; Badagliacca, Roberto; Filomena, Domenico; De Lazzari, Claudio. - In: BIOENGINEERING. - ISSN 2306-5354. - 9:5(2022). [10.3390/bioengineering9050181]

Ventricular and atrial pressure-volume loops. analysis of the effects induced by right centrifugal pump assistance

Papa, Silvia;Badagliacca, Roberto;Filomena, Domenico;De Lazzari, Claudio
2022

Abstract

The main indications for right ventricular assist device (RVAD) support are right heart failure after implantation of a left ventricular assist device (LVAD) or early graft failure following heart transplantation. We sought to study the effects induced by different RVAD connections when right ventricular elastance (Ees(RIGHT)) was modified using numerical simulations based on atrial and ventricular pressure-volume analysis. We considered the effects induced by continuous-flow RVAD support on left/right ventricular/atrial loops when Ees(RIGHT) changed from 0.3 to 0.8 mmHg/mL during in-series or parallel pump connection. Pump rotational speed was also addressed. Parallel RVAD support at 4000 rpm with Ees(RIGHT) = 0.3 mmHg/mL generated percentage changes up to 60% for left ventricular pressure-volume area and external work; up to 20% for left ventricular ESV and up to 25% for left ventricular EDV; up to 50% change in left atrial pressure-volume area (PVLA(L-A)) and only a 3% change in right atrial pressure-volume area (PVLA(R-A)). Percentage variation was lower when Ees(RIGHT) = 0.8 mmHg/mL. Early recognition of right ventricular failure followed by aggressive treatment is desirable, so as to achieve a more favourable outcome. RVAD support remains an option for advanced right ventricular failure, although the onset of major adverse events may preclude its use.
2022
RVAD; cardiovascular modelling; heart failure; lumped parameter model; pressure-volume loop; right-left heart interaction; rotational pump speed; software simulation
01 Pubblicazione su rivista::01a Articolo in rivista
Ventricular and atrial pressure-volume loops. analysis of the effects induced by right centrifugal pump assistance / De Lazzari, Beatrice; Iacovoni, Attilio; Capoccia, Massimo; Papa, Silvia; Badagliacca, Roberto; Filomena, Domenico; De Lazzari, Claudio. - In: BIOENGINEERING. - ISSN 2306-5354. - 9:5(2022). [10.3390/bioengineering9050181]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1655330
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