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Clinical Implications of Physiologic Flow Adjustment in Continuous-Flow Left Ventricular Assist Devices
Mayo Clin, MN USA.
University of Alberta, Canada.
Alameda Health Syst, CA USA.
University of Sydney, Australia.
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2017 (English)In: ASAIO journal (1992), ISSN 1058-2916, E-ISSN 1538-943X, Vol. 63, no 3, 241-250 p.Article, review/survey (Refereed) Published
Abstract [en]

There is increasing evidence for successful management of end-stage heart failure with continuous-flow left ventricular assist device (CF-LVAD) technology. However, passive flow adjustment at fixed CF-LVAD speed is susceptible to flow balancing issues as well as adverse hemodynamic effects relating to the diminished arterial pulse pressure and flow. With current therapy, flow cannot be adjusted with changes in venous return, which can vary significantly with volume status. This limits the performance and safety of CF-LVAD. Active flow adjustment strategies have been proposed to improve the synchrony between the pump and the native cardiovascular system, mimicking the Frank-Starling mechanism of the heart. These flow adjustment strategies include modulation by CF-LVAD pump speed by synchrony and maintenance of constant flow or constant pressure head, or a combination of these variables. However, none of these adjustment strategies have evolved sufficiently to gain widespread attention. Herein we review the current challenges and future directions of CF-LVAD therapy and sensor technology focusing on the development of a physiologic, long-term active flow adjustment strategy for CF-LVADs.

Place, publisher, year, edition, pages
LIPPINCOTT WILLIAMS & WILKINS , 2017. Vol. 63, no 3, 241-250 p.
Keyword [en]
LVAD; flow adjustment; sensors
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:liu:diva-139416DOI: 10.1097/MAT.0000000000000477ISI: 000404043600007PubMedID: 28459742OAI: oai:DiVA.org:liu-139416DiVA: diva2:1129811
Available from: 2017-08-07 Created: 2017-08-07 Last updated: 2017-08-07

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Hübbert, Laila
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Division of Cardiovascular MedicineFaculty of Medicine and Health SciencesDepartment of Cardiology in Linköping
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ASAIO journal (1992)
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CiteExportLink to record
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Citation style
  • apa
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  • modern-language-association-8th-edition
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  • Other style
More styles
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  • de-DE
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