Abstract
345: Median Axial Flow Pump Speed Associated with Cessation of Aortic Valve Opening Is an Indicator of Remission of Chronic Heart Failure in Patients Supported by a Left Ventricular Assist Device

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Purpose

Axial, continuous flow left ventricular assist devices (LVADs) are used to treat refractory heart failure. In some cases, improvement in left ventricular function occurs during LVAD support. Traditional echocardiographic indices have limitations in identifying patients for device explantation. We therefore evaluated the use of speed pump change echocardiograms(echos) to identify the median speed pump in revolutions per minute (rpm) associated with cessation of aortic valve opening as an

Methods and Materials

We identified 15 patients who were supported by the Heartmate II LVAD and had transthoracic speed pump change echos to evaluate myocardial function during LVAD support. We compared the median LVAD pump speed associated with cessation of aortic valve opening in 4 patients(explanted group) who had successful explantation of their device without the need for reimplantation or heart transplantation and 11 patients (nonexplanted group) supported by the LVAD as destination or bridge to transplantion.

Results

The median LVAD speeds(rpms) associated with cessation of aortic valve opening comparing the explanted and nonexplanted group were 9700 (IQR 8700-10500) vs. 9600 (IQR 9000-10000) within 6 wks (p=0.948) and 10,000 (IQR 9800-10500) vs. 9000 (IQR 9000-9450) between 6 wks and 6 months (p= 0.026) post LVAD implant.

Conclusions

The LVAD pump speed associated with complete cessation of aortic valve opening between 6wks and 6 months is significantly higher in the explanted group during LVAD support. LVAD pump speed associated with complete cessation of aortic valve opening seems to be a simple, non-invasive indicator of improvement in myocardial function during LVAD support and should be further prospectively evaluated.

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