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Ultrasound-based prediction of interventricular septum positioning during left ventricular support—an experimental study

Journal of Cardiovascular Translational Research volume 13, pages 1055–1064 (2020)Cite this article

Abstract

The implantation of left ventricular assist devices (LVADs) is often complicated by arrhythmias and right ventricular failure (RVF). Today, the pump speed is titrated to optimize device support using single observations of interventricular septum (IVS) positioning with echocardiographic ultrasound (US). The study demonstrates the applicability of three integrated US transducers in the LVAD cannula to monitor IVS positioning continuously and robustly in real time. In vitro, the predictor of the IVS shift shows an overall prediction error for all volume states of less than 20% and provides a continuous assessment for 99% of cases in four differently sized heart phantoms. The prediction of IVS shift depending on the cannula position is robust for azimuthal and polar deviations of ± 20° and ± 8°, respectively. This intracardiac US concept results in a viable predictor for IVS positioning and represents a promising approach to continuously monitor the IVS and ventricular loading in LVAD patients.

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Acknowledgments

This work is part of the Zurich Heart project under the umbrella of University Medicine Zurich.

Funding

The authors received financial support from the Georg und Bertha Schwyzer-Winiker Foundation, the IMG Foundation, and the ETH Zurich Foundation.

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Affiliations

  1. Product Development Group Zurich, ETH Zurich, CLA G 21.1, Tannenstrasse 3, 8092, Zurich, Switzerland

    Seraina Anne Dual, Lucien Anthamatten, Mirko Meboldt & Marianne Schmid Daners

  2. Cardiothoracic Surgery, Stanford University, Stanford, CA, USA

    Seraina Anne Dual

  3. Department of Heart Failure & Transplantation, Inova Heart and Vascular Institute, Falls Church, VA, USA

    Palak Shah

Authors
  1. Seraina Anne Dual
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  2. Lucien Anthamatten
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  3. Palak Shah
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  4. Mirko Meboldt
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  5. Marianne Schmid Daners
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Corresponding author

Correspondence to Marianne Schmid Daners.

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Conflict of Interest

SA Dual declares that she has no conflict of interest. L Anthamatten declares that he has no conflict of interest. P Shah has received research support from Abbott and Medtronic and he is a consultant of NuPulseCV and Procyrion. M Meboldt declares that he has no conflict of interest, and M Schmid Daners declares that she has no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Dual, S.A., Anthamatten, L., Shah, P. et al. Ultrasound-based prediction of interventricular septum positioning during left ventricular support—an experimental study. J. of Cardiovasc. Trans. Res. 13, 1055–1064 (2020). https://doi.org/10.1007/s12265-020-10034-3

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  • DOI: https://doi.org/10.1007/s12265-020-10034-3

Keywords

  • Adverse events
  • Heart failure
  • Cardiac surgery
  • Hemodynamic monitoring 
  • Ventricular assist device
  • Implantability
  • Phantom model
  • In vitro testing
  • 3D printing