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Phasic coronary blood flow pattern during a continuous flow left ventricular assist support.
Yoshio Ootaki1, Keiji Kamohara, Masatoshi Akiyama
1Department of Biomedical Engineering, Lerner Research Institute, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Summary
Continuous flow left ventricular assist devices (LVADs) reduce total coronary blood flow, particularly in the LAD and LCX arteries. This reduction is more pronounced with increasing LVAD support and in the presence of coronary artery disease.
Area of Science:
- Cardiovascular Physiology
- Medical Devices
- Surgical Interventions
Background:
- Continuous flow left ventricular assist devices (LVADs) are used for heart failure management.
- The impact of reduced pulsatility from LVADs on coronary blood flow is not well understood.
Purpose of the Study:
- To investigate the effects of continuous flow LVAD support on phasic coronary blood flow patterns.
- To assess coronary blood flow dynamics in the presence and absence of coronary stenosis.
Main Methods:
- Phasic coronary blood flow was measured in 16 pigs using flow probes on the LAD, LCX, and RCA.
- Measurements were taken before and after initiating LVAD support, with and without induced LAD stenosis.
Main Results:
- Continuous flow LVAD support decreased total coronary blood flow (TCBF), LAD flow, and LCX flow.
- Systolic flow in the LAD and LCX, and overall RCA flow, decreased, while diastolic RCA flow increased.
- In the presence of LAD stenosis, TCBF and LCX flow decreased with increasing LVAD support.
Conclusions:
- Continuous flow LVADs reduce TCBF, LAD, and LCX flow, primarily due to decreased systolic flow.
- These findings are relevant for understanding myocardial perfusion in LVAD patients, especially those with coronary artery disease.