Mitral valve regurgitation with a rotary left ventricular assist device: the haemodynamic effect of inlet cannulation site and speed modulation

Gregory, Shaun D., Stevens, Michael C., Wu, Eric L., Pauls, Jo P., Kleinheyer, Matthias and Fraser, John F. (2016) Mitral valve regurgitation with a rotary left ventricular assist device: the haemodynamic effect of inlet cannulation site and speed modulation. Annals of Biomedical Engineering, . doi:10.1007/s10439-016-1579-5


Author Gregory, Shaun D.
Stevens, Michael C.
Wu, Eric L.
Pauls, Jo P.
Kleinheyer, Matthias
Fraser, John F.
Title Mitral valve regurgitation with a rotary left ventricular assist device: the haemodynamic effect of inlet cannulation site and speed modulation
Journal name Annals of Biomedical Engineering   Check publisher's open access policy
ISSN 1573-9686
0090-6964
Publication date 2016-03-01
Year available 2016
Sub-type Article (original research)
DOI 10.1007/s10439-016-1579-5
Open Access Status Not Open Access
Total pages 9
Place of publication New York, NY, United States
Publisher Springer New York LLC
Collection year 2017
Language eng
Abstract Mitral valve regurgitation (MVR) is common in patients receiving left ventricular assist device (LVAD) support, however the haemodynamic effect of MVR is not entirely clear. This study evaluated the haemodynamic effect of MVR with LVAD support and the influence of inflow cannulation site and LVAD speed modulation. Left atrial (LAC) and ventricular (LVC) cannulation was evaluated in a mock circulation loop with no, mild, moderate and severe MVR with constant speed and speed modulation (±600 RPM) modes. The use of an LVAD relieved pulmonary congestion during severe MVR, by reducing left atrial pressure from 20.5 to 10.8 (LAC) and 11.5 (LVC) mmHg. However, LAC resulted in decreased left ventricular stroke work (−0.08 J), ejection fraction (−7.9%) and higher MVR volume (+12.7 mL) and pump speed (+100 RPM) compared to LVC. This suggests that LVC, in addition to reducing MVR severity, also improves ventricular washout over LAC. LVAD speed modulation in synchrony with ventricular systole reduced MVR volume and increased ejection fraction with LAC and LVC, thus demonstrating the potential benefits of this mode, despite a reduction in cardiac output.
Keyword Cannula
Heart failure
Mitral valve regurgitation
Speed modulation
Ventricular assist device
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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