Hemodynamics of chronic nonpulsatile flow: implications for LVAD development.
Both experimental and clinical evidence suggest that pulse pressure is not required from a blood pump. End-organ function is well maintained with nonpulsatile systems, though pulse pressure may accelerate recovery from cardiogenic shock. Form follows function, so the effects of reduced pulse pressure on the arterial wall are not surprising. The ability to alter aortic wall morphology by reducing pulse pressure may have important implications for the future treatment of arterial pathology. Both centrifugal and axial-flow pumps can be miniaturized and are silent. Their reliability and user-friendly status may soon allow implantation at an earlier stage of cardiac deterioration. Doubts about the feasibility of long-term pulseless circulation are disappearing.
Saito
Satoshi
S
Tokyo Women's Medical University, Japan.
Nishinaka
Tomohiro
T
Westaby
Stephen
S
D000818:Animals; D002908:Chronic Disease; D003326:Coronary Circulation / Q000502:physiology; D006333:Heart Failure / Q000175:diagnosis* / Q000628:therapy*; D006353:Heart-Assist Devices; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D011379:Prognosis; D011673:Pulsatile Flow / Q000502:physiology; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012770:Shock, Cardiogenic / Q000517:prevention & control; D016896:Treatment Outcome; D014655:Vascular Resistance; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000628:therapy