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Physiologic-insensitive left ventricular assist predisposes right-sided circulatory failure: a pilot simulation and validation study
Authors:Reesink Koen  Dekker André  van der Nagel Theo  Blom Hans  Soemers Cecile  Geskes Gijs  Maessen Jos  van der Veen Erik
Affiliation:Department of Cardiothoracic Surgery, Cardiovascular Research Institute Maastricht, Academic Hospital Maastricht, Maastricht, the Netherlands.
Abstract:
Right-sided circulatory failure (RSCF) is a serious complication in 15-30% of patients receiving a left ventricular assist device (LVAD). It is hypothesized that left ventricular support which lacks physiologic properties predisposes to RSCF. An integral computer simulation and experimental validation protocol was performed. The results suggest that with conventional insensitive left ventricular support right-sided circulatory function is compromised, which may form a substrate for the onset or progress of RSCF. Feedback control of the LVAD could provide a means to counter this problem. A control concept for the LVAD which aims to preserve right-sided circulatory function, while supporting peripheral perfusion, is proposed
Keywords:Assist device––Model simulation––Hemodynamic interaction––Pressure–volume relation––Pulmonary circulation––Left ventricular bypass
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