FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2892038247> ?p ?o ?g. }

• W2892038247 abstract "Introduction Left-ventricular assist devices (LVAD) have emerged as an innovative treatment option for end-stage heart failure. However, right ventricular (RV) failure remains a significant source of morbidity and mortality in this patient population1. Changes affecting both RV preload and afterload after LVAD implantation create considerable changes in RV hemodynamics over time, which have complicated efforts to predict and treat associated right heart failure2-3. While decreasing LVAD speed can be an attractive option to lower RV preload, it has been shown that the RV becomes more sensitive to afterload after LVAD implantation4. Invasive hemodynamic ramp trials can help define the optimal LVAD speed for patients presenting with progressive RV failure. Case Description A 43-year old male with a history of end stage ischemic cardiomyopathy status post HeartWare LVAD implantation listed for transplant admitted with sepsis, worsening heart failure, pulmonary edema and renal impairment . Given his known RV dysfunction he was started on IV milrinone which was not tolerated secondary to systemic hypotension. He was switched to IV epinephrine. Echo performed showed worsening RV systolic function with a TAPSE of only 0.73 cm. An invasive hemodynamic ramp study was done at bedside. The LVAD speed was incrementally increased well above the manufacture's recommended RPM range, from 3,340 to 4,000 RPM ( Table 1 ). This resulted in a marked increase in cardiac output with reduction in PCWP and no significant increase in CVP and was associated with symptomatic relief of dyspnea. He appeared to require higher flows while septic, over the next several days the patient's condition stabilized with improvement in renal function (Cr 3.22 to 1.74 mg/dL). LVAD speed was reduced back to baseline. He eventually was successfully bridged to orthotropic heart transplantation several months after admission. Discussion Sufficient RV function is critical to LV filling and subsequent LVAD function, with reduced RV function associated with worse survival in LVAD patients5. This case highlights the dilemma encountered with the dynamic changes in RV function over time in LVAD patients. While increasing RV preload risks causing conformational changes and overwhelming RV physiologic reserve, increased afterload also jeopardizes RV contractility and pulmonary circulatory resistance6. While caution is warranted in increasing venous return to a weakened RV, this case highlights the importance of adequate LVAD unloading on reducing RV afterload. Ultimately, an invasive hemodynamic ramp study provided much needed clarification on the effect of increasing LVAD speed on right and left-sided filling pressures." @default.
• W2892038247 created "2018-09-27" @default.
• W2892038247 creator A5059574570 @default.
• W2892038247 creator A5063434440 @default.
• W2892038247 creator A5089708941 @default.
• W2892038247 date "2018-08-01" @default.
• W2892038247 modified "2023-09-27" @default.
• W2892038247 title "Speed isn't always Harmful in RV Failure Post LVAD" @default.
• W2892038247 doi "https://doi.org/10.1016/j.cardfail.2018.07.136" @default.
• W2892038247 hasPublicationYear "2018" @default.
• W2892038247 type Work @default.
• W2892038247 sameAs 2892038247 @default.
• W2892038247 citedByCount "1" @default.
• W2892038247 countsByYear W28920382472020 @default.
• W2892038247 crossrefType "journal-article" @default.
• W2892038247 hasAuthorship W2892038247A5059574570 @default.
• W2892038247 hasAuthorship W2892038247A5063434440 @default.
• W2892038247 hasAuthorship W2892038247A5089708941 @default.
• W2892038247 hasConcept C123576724 @default.
• W2892038247 hasConcept C126322002 @default.
• W2892038247 hasConcept C164705383 @default.
• W2892038247 hasConcept C178853913 @default.
• W2892038247 hasConcept C2775932942 @default.
• W2892038247 hasConcept C2776383484 @default.
• W2892038247 hasConcept C2776645727 @default.
• W2892038247 hasConcept C2778198053 @default.
• W2892038247 hasConcept C2778774980 @default.
• W2892038247 hasConcept C48277249 @default.
• W2892038247 hasConcept C71924100 @default.
• W2892038247 hasConcept C78085059 @default.
• W2892038247 hasConceptScore W2892038247C123576724 @default.
• W2892038247 hasConceptScore W2892038247C126322002 @default.
• W2892038247 hasConceptScore W2892038247C164705383 @default.
• W2892038247 hasConceptScore W2892038247C178853913 @default.
• W2892038247 hasConceptScore W2892038247C2775932942 @default.
• W2892038247 hasConceptScore W2892038247C2776383484 @default.
• W2892038247 hasConceptScore W2892038247C2776645727 @default.
• W2892038247 hasConceptScore W2892038247C2778198053 @default.
• W2892038247 hasConceptScore W2892038247C2778774980 @default.
• W2892038247 hasConceptScore W2892038247C48277249 @default.
• W2892038247 hasConceptScore W2892038247C71924100 @default.
• W2892038247 hasConceptScore W2892038247C78085059 @default.
• W2892038247 hasLocation W28920382471 @default.
• W2892038247 hasOpenAccess W2892038247 @default.
• W2892038247 hasPrimaryLocation W28920382471 @default.
• W2892038247 hasRelatedWork W1980299173 @default.
• W2892038247 hasRelatedWork W1980329571 @default.
• W2892038247 hasRelatedWork W2013994714 @default.
• W2892038247 hasRelatedWork W2086495022 @default.
• W2892038247 hasRelatedWork W2169190460 @default.
• W2892038247 hasRelatedWork W2370205175 @default.
• W2892038247 hasRelatedWork W2466103750 @default.
• W2892038247 hasRelatedWork W2892038247 @default.
• W2892038247 hasRelatedWork W4240963671 @default.
• W2892038247 hasRelatedWork W2022605145 @default.
• W2892038247 isParatext "false" @default.
• W2892038247 isRetracted "false" @default.
• W2892038247 magId "2892038247" @default.
• W2892038247 workType "article" @default.