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Published on: February 18, 2022
Choroidal microcirculation in patients with rotary cardiac assist device
Elzbieta Polska1, Heinrich Schima, Georg Wieselthaler
1Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.
Summary
Fully implanted rotary blood pumps maintain ocular microcirculation perfusion in heart failure patients. While pulsatility decreases, mean choroidal blood flow remains stable across varying support levels.
Area of Science:
- Cardiovascular research
- Ophthalmology
- Biomedical engineering
Background:
- Rotary blood pumps are used for long-term cardiac assist in end-stage heart failure.
- These pumps significantly reduce arterial blood flow pulsatility and pressure.
- Assessing end-organ perfusion, especially microcirculation, is crucial.
Purpose of the Study:
- To evaluate the impact of rotary blood pumps on ocular choroidal microcirculation.
- To investigate changes in pulsatile and non-pulsatile blood flow in the choroid.
- To assess the adequacy of ocular microcirculation perfusion under varying pump support.
Main Methods:
- Fundus pulsation amplitude (FPA) and laser Doppler flowmetry were used to assess pulsatility and microcirculation.
- Measurements were taken in three male patients with MicroMed DeBakey VAD at four pump flow levels.
- Ophthalmic artery velocities (PSV, EDV, MFV) were measured using color Doppler imaging.
Main Results:
- Systolic blood pressure increased with higher pump support.
- Fundus pulsation amplitude (FPA) decreased significantly at maximal pump support.
- Mean choroidal blood flow (MFV) remained independent of pump flow, indicating stable perfusion.
Conclusions:
- Mean choroidal blood flow is maintained within therapeutic pump support ranges.
- The ratio of pulsatile to non-pulsatile choroidal flow is altered by rotary blood pumps.
- Ocular microcirculation perfusion is adequately maintained in patients with ventricular assist devices across a range of support.
