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Related Experiment Videos

Right ventricular function during left heart bypass.

A T Miyamoto, S Tanaka, J M Matloff

    The Journal of Thoracic and Cardiovascular Surgery
    |January 1, 1983
    PubMed
    Summary
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    Mechanical support for the left ventricle (LV) can impair right ventricular (RV) function. Studies show increasing left heart bypass flow ratios significantly decrease RV performance, indicating potential need for biventricular support.

    Area of Science:

    • Cardiovascular Physiology
    • Mechanical Circulatory Support

    Background:

    • Right heart failure is a potential complication during left ventricular mechanical support.
    • Understanding right ventricular (RV) functional changes is crucial for managing patients undergoing left ventricular assist device (LVAD) therapy.

    Purpose of the Study:

    • To investigate the impact of varying degrees of left heart bypass (LHBP) on right ventricular (RV) function in a canine model.
    • To determine the critical LHBP flow ratio at which RV function is significantly compromised.

    Main Methods:

    • Eight dogs underwent graded LHBP using a roller pump, with controlled venous return.
    • RV function was assessed by measuring peak RV developed pressure, its first derivative (dp/dt), and mean right atrial (RA) pressure.
    • Left atrial, LV, aortic pressures, and pump flows were continuously monitored.

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    Main Results:

    • Increasing LHBP flow ratios (60%, 90%, 100%) were associated with significant decrements in RV dp/dt.
    • RV dp/dt decreased from a control value of 212 +/- 17 torr/sec to 168 +/- 13 torr/sec at 100% LHBP.
    • These findings suggest RV dysfunction occurs with increasing reliance on LHBP.

    Conclusions:

    • High degrees of LHBP (greater than 90%) may necessitate biventricular bypass or total cardiopulmonary support to ensure adequate body perfusion.
    • Maximizing left ventricular (LV) decompression for reduced myocardial oxygen consumption may not be the optimal strategy during LV mechanical assistance due to potential RV compromise.