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Does septal position affect right ventricular function during left ventricular assist in an experimental porcine
P J Hendry1, K J Ascah, K Rajagopalan
1University of Ottawa Heart Institute, Ottawa Civic Hospital, Ontario, Canada.
Circulation
|November 1, 1994
Summary
Left ventricular assist devices (LVADs) can cause right ventricular (RV) failure. This study found that while LVADs shift the interventricular septum, this shift may benefit RV function under increased afterload conditions.
Area of Science:
- Cardiovascular Surgery
- Medical Devices
- Ventricular Assist Devices
Background:
- Right ventricular (RV) failure is a significant complication in patients with left ventricular assist devices (LVADs).
- The role of interventricular septal (IVS) position in RV failure during LVAD support requires further investigation.
Purpose of the Study:
- To evaluate the impact of interventricular septal (IVS) position on RV function during LVAD support.
- To assess how changes in RV afterload influence RV function with altered IVS position.
Main Methods:
- Seven Yorkshire pigs received Thoratec LVAD implantation.
- RV function was assessed using echocardiography to measure the left ventricular shape index (LVSI), reflecting IVS position.
- Pulmonary artery (PA) constriction was used to alter RV afterload, with and without an intraventricular balloon to modify IVS position.
Main Results:
- LVAD operation caused a significant leftward shift of the IVS (11% decrease in LVSI, P = .01).
- Increased RV afterload exacerbated this leftward shift (14.8% decrease in LVSI, P = .02).
- RV output was lowest when the IVS position was normalized against increased RV afterload, suggesting septal shifting may be beneficial.
Conclusions:
- LVAD unloading of the left ventricle leads to a leftward IVS shift, which does not appear to impair RV function.
- Under conditions of increased RV afterload, the leftward septal shift induced by LVADs may be beneficial for RV function.