Ventricular and atrial pressure—volume loops: analysis of the effects induced by right centrifugal pump assistance

Beatrice De Lazzari, Attilio Iacovoni, Massimo Capoccia*, Silvia Papa, Roberto Badagliacca, Domenico Filomena, Claudio De Lazzari

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)
18 Downloads (Pure)

Abstract

The main indications for right ventricular assist device (RVAD) support are right heart failure after implantation of a left ventricular assist device (LVAD) or early graft failure following heart transplantation. We sought to study the effects induced by different RVAD connections when right ventricular elastance (EesRIGHT) was modified using numerical simulations based on atrial and ventricular pressure−volume analysis. We considered the effects induced by continuous-flow RVAD support on left/right ventricular/atrial loops when EesRIGHT changed from 0.3 to 0.8 mmHg/mL during in-series or parallel pump connection. Pump rotational speed was also addressed. Parallel RVAD support at 4000 rpm with EesRIGHT = 0.3 mmHg/mL generated percentage changes up to 60% for left ventricular pressure−volume area and external work; up to 20% for left ventricular ESV and up to 25% for left ventricular EDV; up to 50% change in left atrial pressure-volume area (PVLAL-A) and only a 3% change in right atrial pressure−volume area (PVLAR-A). Percentage variation was lower when EesRIGHT = 0.8 mmHg/mL. Early recognition of right ventricular failure followed by aggressive treatment is desirable, so as to achieve a more favourable outcome. RVAD support remains an option for advanced right ventricular failure, although the onset of major adverse events may preclude its use.
Original languageEnglish
Article number181
Number of pages17
JournalBioengineering
Volume9
Issue number5
DOIs
Publication statusPublished - 20 Apr 2022

Keywords

  • heart failure
  • RVAD
  • pressure-volume loop
  • lumped parameter model
  • software simulation
  • cardiovascular modelling
  • rotational pump speed
  • right-left heart interaction

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