Original articleAdult cardiacBlood Pressure Control in Continuous Flow Left Ventricular Assist Devices: Efficacy and Impact on Adverse Events
Section snippets
Patients and Methods
All patients at the University of Pittsburgh Medical Center who undergo MCS have their clinical and laboratory data, adverse events, and pump parameters entered prospectively into the Transplant Patient Management System (TPMS) database. All patients consented to their participation in the TPMS database and the University of Pittsburgh Institutional Review Board approved the study.
The study included all patients who underwent implantation of a CF LVAD between January 1, 2006 and October 15,
Results
A total of 108 patients were implanted with a CF LVAD during the study period, 96 of whom were supported over 30 days and included in the final analysis. A total of 12 patients were excluded due to support time of 30 days or less; 8 with a HeartMate II (Thoratec, Pleasanton, CA) (4 deaths, 1 weaned, 3 ongoing) and 4 with a HeartWare (HeartWare International, Inc, Framingham, MA) (1 transplanted, 3 ongoing). Of the 96 CF LVADs, there were 59 HeartMate II, 22 VentrAssist (Ventracor, Sydney,
Comment
Despite the importance of appropriate BP control in MCS patients and recommendations for its treatment, limited information exists regarding effective medication regimens and monitoring protocols 10, 11. Current guidelines for outpatient management of hypertension in patients with CF LVADs only endorse a preference for heart failure medications [10].
Our study demonstrates that most patients with CF LVADs will require medical management of hypertension. Of those patients who did not die on while
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2019, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :Therefore, we think that sufficient cardiac output or LVAD pump flow, not cardiac index, should be achieved to prevent stroke in the acute phase, particularly in patients with small body size. Blood pressure and afterload control have been considered important to prevent strokes.16-18 Because reduction of afterload increases LVAD pump flow, blood pressure control is also important to maintain adequate LVAD pump flow and prevent strokes.