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He, X; Bender, M; Gross, C; Narayanaswamy, K; Laufer, G; Jakubek, S; Bonderman, D; Roehrich, M; Karner, B; Zimpfer, D; Granegger, M.
Left Atrial Decompression With the HeartMate3 in Heart Failure With Preserved Ejection Fraction: Virtual Fitting and Hemodynamic Analysis.
ASAIO J. 2024; 70(2):107-115
Doi: 10.1097/MAT.0000000000002074
Web of Science
PubMed
FullText
FullText_MUG
- Co-Autor*innen der Med Uni Graz
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Laufer Günther
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Zimpfer Daniel
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- Abstract:
- Effective treatment of heart failure with preserved ejection fraction (HFpEF) remains an unmet medical need. Although left atrial decompression using mechanical circulatory support devices was previously suggested, the heterogeneous HFpEF population and the lack of tailored devices have prevented the translation into clinical practice. This study aimed to evaluate the feasibility of left atrial decompression in HFpEF patients with a HeartMate 3 (HM3, Abbott Inc, Chicago, USA) in silico and in vitro . Anatomic compatibility of the HM3 pump was assessed by virtual device implantation into the left atrium through the left atrial appendage (LAA) and left atrial posterior wall (LAPW) of 10 HFpEF patients. Further, the efficacy of left atrial decompression was investigated experimentally in a hybrid mock loop, replicating the hemodynamics of an HFpEF phenotype at rest and exercise conditions. Virtual implantation without substantial intersection with surrounding tissues was accomplished through the LAA in 90% and 100% through the LAPW. Hemodynamic analysis in resting conditions demonstrated normalization of left atrial pressures without backflow at a pump speed of around 5400 rpm, whereas a range of 6400-7400 rpm was required during exercise. Therefore, left atrial decompression with the HM3 may be feasible in terms of anatomic compatibility and hemodynamic efficacy.
- Find related publications in this database (using NLM MeSH Indexing)
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Humans - administration & dosage
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Heart Failure - therapy
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Atrial Appendage - administration & dosage
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Stroke Volume - administration & dosage
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Heart Atria - surgery
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Hemodynamics - administration & dosage
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Decompression - administration & dosage
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Ventricular Function, Left - administration & dosage
- Find related publications in this database (Keywords)
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HFpEF
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HeartMate3
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virtual fitting
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hemodynamics
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hybrid mock loop