Simultaneous ramp right heart catheterization and echocardiography in a ReliantHeart left ventricular assist device.
Many clinicians caring for patients with continuous flow left ventricular assist devices (CF-LVAD) use ramp right heart catheterization (RHC) studies to optimize pump speed and also to troubleshoot CF-LVAD malfunction. An investigational device, the ReliantHeart Heart Assist 5 (Houston, TX), provides the added benefit of an ultrasonic flow probe on the outflow graft that directly measures flow through the CF-LVAD. We performed a simultaneous ramp RHC and echocardiogram on a patient who received the above CF-LVAD to optimize pump parameters and investigate elevated flow through the CF-LVAD as measured by the flow probe. We found that the patient's hemodynamics were optimized at their baseline pump speed, and that the measured cardiac outputviathe Fick principle was lower than that measured by the flow probe. Right heart catheterization may be useful to investigate discrepancies between flow measured by a CF-LVAD and a patient's clinical presentation, particularly in investigational devices where little clinical experience exists. More data is needed to elucidate the correlation between the flow measured by an ultrasonic probe and cardiac output as measured by RHC.
Dipanjan Banerjee, Debleena Dutt, Sebastien Duclos, Karim Sallam, Matthew Wheeler, Richard Ha, Divisions of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States.
Dipanjan
D
Banerjee
Dipanjan Banerjee, Debleena Dutt, Sebastien Duclos, Karim Sallam, Matthew Wheeler, Richard Ha, Divisions of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States.
Debleena
D
Dutt
Dipanjan Banerjee, Debleena Dutt, Sebastien Duclos, Karim Sallam, Matthew Wheeler, Richard Ha, Divisions of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States.
Sebastien
S
Duclos
Dipanjan Banerjee, Debleena Dutt, Sebastien Duclos, Karim Sallam, Matthew Wheeler, Richard Ha, Divisions of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States.
Karim
K
Sallam
Dipanjan Banerjee, Debleena Dutt, Sebastien Duclos, Karim Sallam, Matthew Wheeler, Richard Ha, Divisions of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States.
Matthew
M
Wheeler
Dipanjan Banerjee, Debleena Dutt, Sebastien Duclos, Karim Sallam, Matthew Wheeler, Richard Ha, Divisions of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States.
Richard
R
Ha
Flow estimation; Left ventricular assist devices; Ramp study; Right heart catheterization