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1. NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 14, 2018, No. 2 , , ,

Assist Devices (LVAD).
Assist Devices (LVAD).
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ORTHOSTATIC CEREBRAL HEMODYNAMICS IN PATIENTS WITH LEFTVENTRICULAR ASSIST DEVICES (LVAD)
ORTHOSTATIC CEREBRAL HEMODYNAMICS IN PATIENTS WITH LEFTVENTRICULAR ASSIST DEVICES (LVAD)
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Meanwhile, the third generation of left ventricular assist devices (LVAD) has been developed and the initial “bridging therapy” to transplant is rather developing into a long-term option for years.
Mechanical support of the cardiac output function is a growing therapy option worldwide since the increasing number of patients with cardiac failure needs alternatives to rarely available heart transplants. Previous TCD studies had shown that some devices generate cerebral microemboli. Meanwhile, the third generation of left ventricular assist devices (LVAD) has been developed and the initial “bridging therapy” to transplant is rather developing into a long-term option for years. The blood volume output of the LVAD depends on preloading capacity and the peripheral resistance. However, the consequences of the nonpulsatile continuous blood flow and the cerebral autoregulation for the cerebral perfusion still remain unclear.
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The blood volume output of the LVAD depends on preloading capacity and the peripheral resistance.
Mechanical support of the cardiac output function is a growing therapy option worldwide since the increasing number of patients with cardiac failure needs alternatives to rarely available heart transplants. Previous TCD studies had shown that some devices generate cerebral microemboli. Meanwhile, the third generation of left ventricular assist devices (LVAD) has been developed and the initial “bridging therapy” to transplant is rather developing into a long-term option for years. The blood volume output of the LVAD depends on preloading capacity and the peripheral resistance. However, the consequences of the nonpulsatile continuous blood flow and the cerebral autoregulation for the cerebral perfusion still remain unclear.
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We investigated 25 consecutive patients a few month after implantation of a LVAD in our rehabilitation department.
We investigated 25 consecutive patients a few month after implantation of a LVAD in our rehabilitation department. By means of transcranial ultrasound sonography (TCD, 2 MHz probe, head fixation) of the middle cerebral artery (MCA), the cerebral blood flow velocity (CBFV) was recorded and the mean CBFV was calculated. Patients were first recorded in supine positon and then brought into standing position. We measured the mean CBFV after standing up and registered any symptoms ranging from dizziness to even postural control failures.
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