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Implantation of the Syncardia Total Artificial Heart

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Cardiac exercise hemodynamics late after partial left ventriculectomy.

K B James¹, G Haas, S R Lutton

¹Department of Cardiology, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.

|November 18, 2000

Summary

Patients undergoing partial left ventriculectomy (PLV) show improved cardiac index during exercise. However, abnormal pulmonary pressures and reduced oxygen levels persist, indicating potential compliance issues late after surgery.

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Area of Science:

Cardiology
Cardiovascular Physiology
Heart Failure Surgery

Background:

Partial left ventriculectomy (PLV) is a surgical procedure for heart failure.
Patient-reported activity levels after PLV can be favorable.
The exercise physiology following PLV remains incompletely understood.

Purpose of the Study:

To describe the exercise hemodynamics in patients long after partial left ventriculectomy.
To investigate the physiological response to exercise in this patient group.

Main Methods:

Upright bicycle exercise testing was performed in 10 patients (9 men) an average of 1.7 years post-PLV.
Hemodynamic parameters including pulmonary artery pressure, pulmonary capillary wedge pressure, cardiac index, and mixed venous oxygenation were measured.
Pulmonary vascular resistance was also assessed during exercise.

Main Results:

Cardiac index significantly increased with exercise (2.2 to 3.8 L/min/m²).
Pulmonary artery pressure and pulmonary capillary wedge pressure showed significant increases during exercise.
Mixed venous oxygenation markedly declined with exercise (44% to 24%).

Conclusions:

Late after PLV, exercise leads to a significant augmentation of cardiac index.
Elevated pulmonary artery and wedge pressures suggest abnormal compliance.
The significant decline in mixed venous oxygenation warrants further investigation for optimizing heart failure management.