Case Report: Disparate flow in HeartMate II patient with extensive left ventricle repair. (May 2016)

• Record Type: Journal Article
• Authors: Tran, Phat L.; Kazui, Toshinobu; Perovic, Viktor; Mikail, Philmon; Lick, Scott; Smith, Richard; Betterton, Edward W.; Venkat, Raj; Iwanski, Jessika; Wong, Raymond K.; Slepian, Marvin J.; Khalpey, Zain
• Is Part Of: Perfusion. Volume 31:Number 4(2016)
• Page Start: 349
• Page End: 352
• Publication Date: 2016-05
• Subjects: mechanical circulatory support (MCS) -- left ventricular assist device (LVAD) -- Donovan mock circulation system (DMCS) -- HeartMate II (HMII) -- ventricle repair/reconstruction; Perfusion (Physiology) -- Periodicals; Blood -- Circulation, Artificial -- Periodicals; Heart -- Surgery -- Periodicals; Extracorporeal Circulation -- Periodicals; Perfusion -- Periodicals; Circulation extracorporelle -- Périodiques; Perfusion -- Périodiques; 617.41
• DOI: 10.1177/0267659115614639
• Languages: English
• ISSNs: 0267-6591

Abstract

This case study reports the operative management of a 63-year-old male patient following implantation of the HeartMate II (HMII) left ventricular assist device (LVAD), with a non-compliant left ventricle (LV) and a reduced right ventricular (RV) end-diastolic volume. Intraoperatively, the patient had a thin, fragile LV wall with laminated clot; a ventricular septal defect was encountered during removal of the clot. Along with an aortic valve repair, the LV and the septum were reconstructed with multiple bovine pericardium patches, thus, moderately reducing the RV and LV stroke volume. A difference in cardiac output via a Swan-Ganz catheter (approximately 1.5 l/min) was observed as opposed to the HMII's estimated flow. The result was later replicated and verified in vitro via the Donovan Mock Circulation System (DMCS), where about 2 l/min lower flow on the HMII system was observed. In conclusion, the HMII flow rate displayed can be inaccurate and should only be used for trending.