Right heart function during left heart assist and the effects of volume loading in a canine preparation.

Abstract:

:A significant fraction of patients in whom mechanical left ventricular assist devices are implanted for refractory cardiac failure after open heart surgery have had the complication of right heart failure. To evaluate the effects of left ventricular assistance and pressure unloading on right ventricular function, we performed experiments in the normal hearts of open-chest, anesthetized, large mongrel dogs. We compared right ventricular function before and after left ventricular-to-aortic bypass with a roller pump at right atrial pressure levels of 1, 3, 5, and 7 mm Hg produced by volume loading. No significant changes were found in cardiac output or stroke volume over this range of right atrial pressures when comparing that before to that during left ventricular bypass, which at a right atrial pressure of 1 mm Hg reduced peak left ventricular pressure from 96 +/- 6 to 15 +/- 9 mm Hg and at a right atrial pressure of 5 mm Hg reduced it from 113 +/- 3 to 29 +/- 12 mm Hg, while maintaining aortic pressure. There was no evidence of right ventricular failure under these conditions: (from before to during bypass) at a right atrial pressure of 1 mm Hg cardiac output was 3.4 +/- 0.4 to 3.7 +/- 0.6 liter/min and stroke volume was 28 +/- 5 to 33 +/- 6 ml; during volume loading at a right atrial pressure of 7 mm Hg cardiac output was 5.6 +/- 0.6 to 5.7 +/- 0.7 liter/min and stroke volume was 47 +/- 5 to 52 +/- 5 ml.(ABSTRACT TRUNCATED AT 250 WORDS)

journal_name

Circulation

journal_title

Circulation

authors

Farrar DJ,Compton PG,Dajee H,Fonger JD,Hill JD

doi

10.1161/01.cir.70.4.708

subject

Has Abstract

pub_date

1984-10-01 00:00:00

pages

708-16

issue

4

eissn

0009-7322

issn

1524-4539

journal_volume

70

pub_type

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