title: Case Report: Disparate flow in HeartMate II patient with extensive left ventricle repair.
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 ITALIC! in vitrovia 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.
authors.affiliation: Department of Medicine, University of Arizona, Tucson, AZ, USA Artificial Heart Program, University of Arizona, Tucson, AZ, USA Department of Pharmacology, University of Arizona, Tucson, AZ, USA.
authors.forename: Phat L
authors.initials: PL
authors.lastname: Tran
authors.affiliation: Artificial Heart Program, University of Arizona, Tucson, AZ, USA CardioThoracic Surgery, University of Arizona, Tucson, AZ, USA.
authors.forename: Toshinobu
authors.initials: T
authors.lastname: Kazui
authors.affiliation: Department of Medicine, University of Arizona, Tucson, AZ, USA.
authors.forename: Viktor
authors.initials: V
authors.lastname: Perovic
authors.affiliation: Biomedical Engineering, University of Arizona, Tucson, AZ, USA.
authors.forename: Philmon
authors.initials: P
authors.lastname: Mikail
authors.affiliation: Department of Medicine, University of Arizona, Tucson, AZ, USA Artificial Heart Program, University of Arizona, Tucson, AZ, USA CardioThoracic Surgery, University of Arizona, Tucson, AZ, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Lick
authors.affiliation: Artificial Heart Program, University of Arizona, Tucson, AZ, USA CardioThoracic Surgery, University of Arizona, Tucson, AZ, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Smith
authors.affiliation: Artificial Heart Program, University of Arizona, Tucson, AZ, USA.
authors.forename: Edward W
authors.initials: EW
authors.lastname: Betterton
authors.affiliation: Artificial Heart Program, University of Arizona, Tucson, AZ, USA.
authors.forename: Raj
authors.initials: R
authors.lastname: Venkat
authors.affiliation: Artificial Heart Program, University of Arizona, Tucson, AZ, USA Department of Pharmacology, University of Arizona, Tucson, AZ, USA.
authors.forename: Jessika
authors.initials: J
authors.lastname: Iwanski
authors.affiliation: Artificial Heart Program, University of Arizona, Tucson, AZ, USA Department of Pharmacology, University of Arizona, Tucson, AZ, USA.
authors.forename: Raymond K
authors.initials: RK
authors.lastname: Wong
authors.affiliation: Department of Medicine, University of Arizona, Tucson, AZ, USA Biomedical Engineering, University of Arizona, Tucson, AZ, USA.
authors.forename: Marvin J
authors.initials: MJ
authors.lastname: Slepian
authors.affiliation: Department of Medicine, University of Arizona, Tucson, AZ, USA Artificial Heart Program, University of Arizona, Tucson, AZ, USA CardioThoracic Surgery, University of Arizona, Tucson, AZ, USA Biomedical Engineering, University of Arizona, Tucson, AZ, USA zkhalpey@surgery.arizona.edu.
authors.forename: Zain
authors.initials: Z
authors.lastname: Khalpey
mesh_terms: D000818:Animals; D002417:Cattle; D006345:Heart Septal Defects, Ventricular / Q000503:physiopathology / Q000601:surgery; D006352:Heart Ventricles / Q000503:physiopathology / Q000601:surgery; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure
keywords: Donovan mock circulation system (DMCS); HeartMate II (HMII); left ventricular assist device (LVAD); mechanical circulatory support (MCS); ventricle repair/reconstruction