This case report illustrates the challenges in managing patients with centrifugal ventricular assist devices (VADs). As these devices have evolved, their physical properties have changed, impacting patient management. Levitated centrifugal pumps have a non-linear response to afterloads. The device output will decrease significantly in the presence of high systemic vascular resistance. Blood pressure control is integral to the management of patients in the immediate and later postoperative period.
RoseE.A., GelijnsA.C., MoskowitzA.J.Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) Study Group. Long-term use of a left ventricular assist device for end-stage heart failure. N Engl J Med.2001; 345(20): 1435–1443.
2.
HeilmannC., GeisenU., BenkC.Haemolysis in patients with ventricular assist devices: major differences between systems. Eur J Cardiothorac Surg.2009; 36(3): 580–584.
3.
SlaughterM.S., IsingM.S., TamezD.Increase in circadian variation after continuous-flow ventricular assist device implantation. J Heart Lung Transplant.2010; 29(6): 695–697.
4.
HuntS.A., AbrahamW.T., ChinM.H.American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation.2005; 112(12): e154–e235.
5.
MyersT.J., BolmersM., GregoricI.D., KarB., FrazierO.H.Assessment of arterial blood pressure during support with an axial flow left ventricular assist device. J Heart Lung Transplant.2009; 28(5): 423–427.
