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KMID : 0191120110260121591
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Journal of Korean Medical Science
2011 Volume.26 No. 12 p.1591 ~ p.1598
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Theoretical Estimation of Cannulation Methods for Left Ventricular Assist Device Support as a Bridge to Recovery
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Lim Ki-Moo
Lee Jeong-Sang
Song Jin-Ho
Youn Chan-Hyun
Choi Jae-Sung
Shim Eun-Bo
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Abstract
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Left ventricular assist device (LVAD) support under cannulation connected from the left atrium to the aorta (LA-AA) is used as a bridge to recovery in heart failure patients because it is non-invasive to ventricular muscle. However, it has serious problems, such as valve stenosis and blood thrombosis due to the low ejection fraction of the ventricle. We theoretically estimated the effect of the in-series cannulation, connected from ascending aorta to descending aorta (AA-DA), on ventricular unloading as an alternative to the LA-AA method. We developed a theoretical model of a LVAD-implanted cardiovascular system that included coronary circulation. Using this model, we compared hemodynamic responses according to various cannulation methods such as LA-AA, AA-DA, and a cannulation connected from the left ventricle to ascending aorta (LV-AA), under continuous and pulsatile LVAD supports. The AA-DA method provided 14% and 18% less left ventricular peak pressure than the LA-AA method under continuous and pulsatile LVAD conditions, respectively. The LA-AA method demonstrated higher coronary flow than AA-DA method. Therefore, the LA-AA method is more advantageous in increasing ventricular unloading whereas the AA-DA method is a better choice to increase coronary perfusion.
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KEYWORD
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Left Ventricular Assist Device (LVAD), Cannulation Methods, Bridge to Recovery, Ventricular Unloading
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