It’s critical to optimize clinical outcomes of VAD support for shunted single ventricle patients. “Hemodynamic Response to Device Titration in the Shunted Single Ventricle Circulation: A Patient Cohort Modeling Study” was published online in ASAIO Journal on March 29, 2021. The study aimed to understand the response to VAD titration with a lumped-parameter network. Using hemodynamic data from six patients with a systemic-to-pulmonary shunt, the authors constructed simulated cases of heart failure and hemodynamic response.
- When VAD flow was increased, the pulmonary arterial pressure stayed relatively constant in 5 cases and increased in 1 case.
- The mean VAD flow needed was 6.5 ± 1.2 L/min/m2 to reach an arterial-venous O2 saturation difference of 30%. This is a higher VAD flow than needed in the equivalent non-shunted scenario due to the partial diversion of flow to the pulmonary circulation.
There is significant patient-specific variation in hemodynamic responses to VAD support. The authors conclude that hemodynamic modeling might be helpful in identifying patients who may benefit the most from VAD support and guiding an individualized approach to perioperative VAD management.
The authors consist of ACTION members:
- Chet Villa, Farhan Zafar, and Angela Lorts, Cincinnati Children’s Hospital Medical Center
- Ethan Kung, Clemson University.
Villa C, Zafar F, Lorts A, Kung E. Hemodynamic Response to Device Titration in the Shunted Single Ventricle Circulation: A Patient Cohort Modeling Study. ASAIO J. 2021 Mar 29. doi: 10.1097/MAT.0000000000001433. Epub ahead of print. PMID: 33788799.