J Korean Med Sci.  2014 Jan;29(1):137-140. 10.3346/jkms.2014.29.1.137.

The Successful Implantation of Continuous-Flow Left Ventricular Assist Device as a Destination Therapy in Korea: Echocardiographic Assessment

• Lee GY
• Park SJ
• Kim S
• Choi N
• Jeong DS
• Jeon ES
• Lee YT

• KMID: 1796927
• DOI: http://doi.org/10.3346/jkms.2014.29.1.137

Abstract

Left ventricular assist device (LVAD) is a good treatment option for the patients ineligible for cardiac transplantation. Several studies have demonstrated that a ventricular assist device improves the quality of life and prognosis of the patients with end-stage heart failure. A 75-yr-old man debilitated with New York Heart Association (NYHA) functional class III-IV due to severe left ventricular systolic dysfunction received LVAD implantation as a destination therapy. The patient was discharged with improved functional status (NYHA functional class II) after appropriate cardiac rehabilitation and education about how to manage the device and potential emergency situations. This is the first case of successful continuous-flow LVAD implantation as a destination therapy in Korea.

Keyword

Heart Failure; Mechanical Circulatory Support; Heart-Assist Device; HeartMate II

MeSH Terms

Aged
Dyspnea
Echocardiography
Heart Failure/*surgery
*Heart-Assist Devices
Humans
Male
Prosthesis Implantation
Quality of Life
Republic of Korea
Treatment Outcome
Ventricular Dysfunction, Left/*surgery

Figure

• 

  Fig. 1 Chest X-ray after LVAD implantation. (The illustration of outflow graft is added on the patient's chest radiography)

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  Fig. 2 Checkpoint in echocardiographic assessment after LVAD implantation. (A, B) The axis and laminar flow of inflow conduit in modified apical-4-chamber view, (C) The position of interventricular septum (IVS) and interatrial septum (IAS), (D, E) The flow of inflow cannula in right parasternal view, and (F) IVC diameter in subcostal view.

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  Fig. 3 Hemodynamic change after LVAD implantation. Before the procedure, (A) Left ventricle was severely dilated, (B) IVS and IAS were deviated to right side due to increased left ventricular filling pressure, (C) IVC was dilated, (D) Functional mitral regurgitation of mild degree was observed. After LVAD implantation, (E) LV dimension and (G) IVC diameter were decreased, (F) IVS and IAS appeared in midline position, and (H) Functional MR was significantly decreased.

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