Korean Circ J.  2001 Jul;31(7):670-680. 10.4070/kcj.2001.31.7.670.

Simulation of the Effects of Long-term Implantation of Biventricular Assist Device on the Hemodynamic Parameters in Heart Failure

• Oh S
• Sohn DW
• Oh BH
• Min BG
• Sun K

• KMID: 2029553
• DOI: http://doi.org/10.4070/kcj.2001.31.7.670

Abstract

BACKGROUND AND OBJECTIVES
Ventricular assist device(VAD) was developed for the bridge to cardiac transplantation, but the current research trends proceed to the purpose of bridge to cardiac recovery. We investigated the effects of long-term VAD implantation on the hemodynamic parameters related to the prognosis of heart failure by simulation to provide the preclinical and clinical applicability. MATERIAL AND METHODS: A moving-actuator type artificial heart developed by Seoul National University Artificial Heart Laboratory was used as a model of biventricular assist device. We set initial values of hemodynamic parameters according to the guideline of VAD implantation, and performed simulation of the change of hemodynamic variables related to successful device weaning and the prognosis of heart failure.
RESULTS
Cardiac indices (CIs) at 1 hour and 6 months after VAD implantation were 2.98 l/min/m2 and 2.60 l/min/m2, respectively. Systolic/diastolic/mean aorta pressure were 121/84/99 mmHg at 6 months after VAD implantation. During pump-off state at 6 month, each value of hemodynamic parameters were as follows: CI 2.53 l/min/m2, pulmonary capillary wedge pressure 10 mmHg, left ventricular end-diastolic volume 105 ml, left ventricular ejection fraction 0.58, mean aorta pressure 84 mmHg, end-systolic wall stress 108 kdyn/cm2. Peak rate of change of power(peak dPWR(t)/dt) was 5.62x108 dyneXcm/s2 after 6-month VAD implantation. In a real VAD-implanted patient, simulation data were partly compatible with real hemodynamic data, especially in the aspects of predicting VAD weaning.
CONCLUSION
Long-term VAD implantation partially improved the values of hemodynamic parameters related to the prognosis, and this simulation results will provide the basic concept and applicability of clinical trial for end-stage heart failure.

Keyword

ventricular assist device; heart failure; prognosis; hemodynamics; simulation

MeSH Terms

Aorta
Heart Failure*
Heart Transplantation
Heart*
Heart, Artificial
Heart-Assist Devices
Hemodynamics*
Humans
Prognosis
Pulmonary Wedge Pressure
Seoul
Stroke Volume
Weaning