Phasic coronary blood flow pattern during a continuous flow left ventricular assist support

Ootaki, Yoshio; Kamohara, Keiji; Akiyama, Masatoshi; Zahr, Firas; Kopcak, Michael W.; Dessoffy, Raymond; Fukamachi, Kiyotaka
November 2005
European Journal of Cardio-Thoracic Surgery;Nov2005, Vol. 28 Issue 5, p711
Academic Journal
Abstract: Objective: Continuous flow left ventricular assist devices (LVADs) have been introduced and tested as a bridge to heart transplantation, bridge to recovery, and destination therapy, and several studies have been conducted to assess the physiologic effects of continuous flow LVADs. However, the effect of reduced pulsatility on the phasic coronary blood flow pattern is unknown. The aim of this study was to investigate the phasic coronary blood flow patterns during continuous flow LVAD support. Methods: Phasic coronary blood flow patterns and hemodynamic data were analyzed using three flow probes placed around the left anterior descending coronary artery (LAD), left circumflex coronary artery (LCX), and the right coronary artery (RCA) in 16 pigs before and after initiating the LVAD support with or without creating LAD stenosis. Results: The total coronary blood flow (TCBF, 112.8±31.4mL/min) gradually decreased when the continuous flow LVAD support increased to 2.0L/min (110.7±29.0mL/min, P =0.571), 2.5L/min (103.7±26.1mL/min, P =0.079), and 3.0L/min (101.5±27.2mL/min, P =0.027) because of decreases in LAD flow and LCX flow. LVAD support caused decrease in systolic and peak systolic LAD flow, LCX flow, and RCA flow, whereas diastolic RCA flow increased. In the presence of LAD stenosis, the TCBF (97.7±36.1mL/min) decreased when the continuous flow LVAD support increased to 2.0L/min (83.9±22.1mL/min, P =0.029), 2.5L/min (83.2±25.2mL/min, P =0.012), and 3.0L/min (87.6±23.4mL/min, P =0.005) because of decreases in LCX flow. Conclusion: Use of a continuous flow LVAD decreased TCBF, LAD flow, and LCX flow secondary to reduced systolic LAD flow and LCX flow, and decreased TCBF and LCX flow in the presence of LAD stenosis. These findings are potentially relevant to understanding the physiology of myocardial blood perfusion during continuous flow LVAD support especially in patients with coronary artery disease.


Related Articles

  • Evaluation of Successful PTCA by Transstenotic Flow Velocity Ratios. Altstidl, Robert; Regenfus, Matthias; Lehmkuhl, Hans; Dill, Harald; Bachmann, Kurt // Angiology;Sep1997, Vol. 48 Issue 9, p775 

    Doppler probes mounted on the tip of a guidewire allow the measurement of coronary blood flow velocities, not only proximal but also distal to stenoses eligible for percutaneous transluminal coronary angioplasty (PTCA). The objective of this study was to determine the improvement of...

  • 1062 Transesophageal Doppler assessment of coronary blood flow in the diagnosis of main coronary artery stenoses Vrublevsky, A.; Boshchenko, A.; Karpov, R. // European Journal of Echocardiography;Dec2006 Supplement 1, Vol. 7, pS181 

    An abstract of the article "Transesophageal Doppler assessment of coronary blood flow in the diagnosis of main coronary artery stenoses," by A. Vrublevsky and colleagues is presented.

  • Effect of Experimental Stenosis on the Vibration of the Porcine Aortic Wall. Tsatsaris, Athanasios; Iliopoulos, Dimitrios; Baldoukas, Antonios; Dontas, Ismene; Triantafyllou, Dimitrios; Berketis, Nikolaos; Triantafyllou, Ioannis // Vascular Disease Prevention;Jan2006, Vol. 3 Issue 1, p11 

    Objective: To study the vibration adaptation of the aortic wall, after experimentally-induced stenosis in pig descending thoracic aorta. Methods: A 5 mm length, circumferential, rigid, symmetric constriction was created surgically, in eight healthy pigs, producing approximately a 15-20 mmHg...

  • Effect of target artery location and severity of stenosis on mid-term patency of aorta-anastomosed vs. internal thoracic artery-anastomosed radial artery grafts Gaudino, Mario; Alessandrini, Francesco; Pragliola, Claudio; Cellini, Carlo; Glieca, Franco; Luciani, Nicola; Girola, Fabiana; Possati, Gianfederico // European Journal of Cardio-Thoracic Surgery;Mar2004, Vol. 25 Issue 3, p424 

    Objective: To verify the effect of location and severity of stenosis of the target coronary artery (TCA) on mid-term patency of aorta-anastomosed vs. internal thoracic artery (ITA)-anastomosed radial artery (RA) graft. Methods: During a 3-year period 228 consecutive patients received an RA graft...

  • Impact of alcohol septal ablation on left anterior descending coronary artery blood flow in hypertrophic obstructive cardiomyopathy. Willem van Dockum; Paul Knaapen; Mark Hofman; Joost Kuijer; Folkert ten Cate; Jurrien ten Berg; Aernout Beek; Jos Twisk; Albert van Rossum // International Journal of Cardiovascular Imaging;Jun2009, Vol. 25 Issue 5, p511 

    Abstract   Objectives The aim of this study was to evaluate the effects of alcohol septal ablation (ASA) on coronary blood flow in symptomatic hypertrophic obstructive cardiomyopathy (HOCM) using cardiac MR (CMR) coronary flow measurements. Background CMR flow mapping enables...

  • INTERPLAY OF VARIOUS FACTORS AFFECTING CORONARY BLOOD FLOW. Trinker, Fedora R. // Australian Journal of Experimental Biology & Medical Science;Aug1969, Vol. 47 Issue 4, pP32 

    Presents a study about the interplay of various factors affecting coronary blood flow.

  • Down-regulation of the ERK1 and ERK2 mitogen-activated protein kinases using antisense oligonucleotides inhibits intimal hyperplasia in a porcine model of coronary balloon angioplasty. Liu, Bo; Fisher, Michael; Groves, Peter // Cardiovascular Research;Jun2002, Vol. 54 Issue 3, p640 

    Objective: Neointimal hyperplasia is a central feature in the pathogenesis of a variety of vascular pathologies. Mitogen-activated protein kinases (MAPK) are involved in the downstream transduction of signals from receptors for many of the molecules known to be instrumental in this...

  • Influence of slow coronary blood flow on stenosis morphology. Tomai, Fabrizio; Ghini, Anna S.; Danesi, A. // Heart;Aug2001, Vol. 86 Issue 2, p171 

    This article discusses influence of slow coronary blood flow on stenosis morphology. A 62 year old man was admitted because of frequent episodes of palpitation and chest pain. Two dimensional echocardiography showed hypokinesis of the posterolateral wall with preserved global left ventricular...

  • HEMODYNAMIC STUDIES OF ARTERIAL STENOSIS. Weale, F. E. // Vascular Surgery;Mar1968, Vol. 2 Issue 1, p21 

    The bilaminar concept of blood flow in which the cross-sectional area of a blood vessel is subdivided into an axial and a resistance stream is quantitatively analyzed. In 28 dogs the relation between the cross-sectional area of a variable stenosis and the pressure differential across it is shown...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics