3 ms·
That continuous flow is new(-ish). My father had an LVAD in 2002, and it was the older type that actually pumps rhythmically, so that was his pulse. At the time
by peff 10y ago
That continuous flow is new(-ish). My father had an LVAD in 2002, and it was the older type that actually pumps rhythmically, so that was his pulse. At the time continuous-flow models were in research, and I do remember there were concerns with thrombosis (basically, the shifting force of the pulse helps break up clots).
I don't know the current state of the art, but there are definitely studies (the keyword is "pulsatile"). For example:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4250555/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4250555/
For comparison, here's a picture of some LVADs. The one I've seen in person (after it had been taken back out!) is the one on the far left. Flow issues aside, I can imagine the smaller ones are easier on the patient in general, just from the perspective of surgery trauma.
http://reliantheart.com/wp-content/uploads/2013/04/VAD_Size_Comparison.jpg http://reliantheart.com/wp-content/uploads/2013/04/VAD_Size_...
- forgotpwagain 10y agoTo elaborate a little bit more: the first generation of LVADs were had large mechanical pumps and were huge -- they could only be implanted in people with a large chest cavity, excluding a large number of patients (especially women) from eligibility for their device. Current popular models are continuous flow rotors that are much smaller (enabling their use in almost anyone) and are non-pulsatile. However, there's been a big push to move towards pulsatile devices. This is mostly driven by mechanobiolgy studies that show that there is a difference in the cellular programs of cells that are exposed to a continuous shear force versus a pulsatile shear force. Accordingly, to more closely replicate the natural physiology of the heart, there has been a big push towards using pulsatile devices.