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Perfusion, Vol. 22, No. 1, 63-66 (2007)
DOI: 10.1177/0267659106074784
© 2007 SAGE Publications

Pulse wave analysis to assess systemic blood flow during mechanical biventricular support

Sabino Scolletta

Department of Cardiothoracic Anesthesia, University of Siena, Siena, Italy, scolletta{at}unisi.it

Igor D Gregoric

Department of Cardiovascular Surgery, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas

Luigi Muzzi

Department of Cardiothoracic Anesthesia, University of Siena, Siena, Italy

Branislav Radovancevic

Department of Cardiovascular Surgery, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas

O Howard Frazier

Department of Cardiovascular Surgery, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas

Measurement of systemic blood flow is of crucial importance in patients on mechanical circulatory support (MCS). We reported the case of a 65-year-old female patient in severe cardiogenic shock undergoing left (Jarvik 2000 axial flow pump) and right (Levitronix-Centrimag centrifugal pump) ventricular assist device implant. Evaluation of blood flow was obtained by ultrasonic flowmetry, continuous thermodilution technique, and pressure recording analytical method (PRAM). This pulse contour system allows beat-by-beat systemic blood flow assessment from the analysis of radial artery pressure waveform. At a Jarvik pump speed ≤ 10 000 rotations per minutes (rpm), thermodilution and PRAM showed similar blood flow values. At a Jarvik pump speed ≥11 000 rpm, the aortic valve did not open and PRAM did not provide blood flow values due to nonpulsatile blood flow. The present paper describes the first experience with PRAM in a single patient on MCS. Further studies are required to assess the validity of PRAM as an additional monitoring system in the setting of ventricular assist device support. Perfusion (2007) 22, 63-66.


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