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Advances and Future Directions for Mechanical Circulatory Support

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Presentation on theme: "Advances and Future Directions for Mechanical Circulatory Support"— Presentation transcript:

1 Advances and Future Directions for Mechanical Circulatory Support
Michelle Capdeville, MD, Nicholas G. Smedira, MD  Anesthesiology Clinics  Volume 31, Issue 2, Pages (June 2013) DOI: /j.anclin Copyright © 2013 Elsevier Inc. Terms and Conditions

2 Fig. 1 HeartMate II LVAD in situ. Left ventricular inflow cannula is located at LV apex; outflow cannula is anastomosed to the ascending aorta. Anesthesiology Clinics  , DOI: ( /j.anclin ) Copyright © 2013 Elsevier Inc. Terms and Conditions

3 Fig. 2 HeartMate II axial flow pump showing titanium-coated internal rotor. (Courtesy of Thoratec Corporation, Pleasanton, CA, USA.) Anesthesiology Clinics  , DOI: ( /j.anclin ) Copyright © 2013 Elsevier Inc. Terms and Conditions

4 Fig. 3 Chest radiograph showing HeartMate II LVAD in situ.
(Courtesy of Thoratec Corporation, Pleasanton, CA, USA.) Anesthesiology Clinics  , DOI: ( /j.anclin ) Copyright © 2013 Elsevier Inc. Terms and Conditions

5 Fig. 4 Graphic illustration of pressure-flow relationship at various pump speeds. Anesthesiology Clinics  , DOI: ( /j.anclin ) Copyright © 2013 Elsevier Inc. Terms and Conditions

6 Fig. 5 TEE 4-chamber view showing proper positioning of LV apical inflow cannula. Anesthesiology Clinics  , DOI: ( /j.anclin ) Copyright © 2013 Elsevier Inc. Terms and Conditions

7 Fig. 6 TEE 4-chamber view with color flow Doppler showing laminar flow in the apical inflow cannula. Anesthesiology Clinics  , DOI: ( /j.anclin ) Copyright © 2013 Elsevier Inc. Terms and Conditions

8 Fig. 7 Pulse wave Doppler of LV apical inflow cannula showing normal velocities (see text) and laminar flow. Anesthesiology Clinics  , DOI: ( /j.anclin ) Copyright © 2013 Elsevier Inc. Terms and Conditions

9 Fig. 8 TEE long-axis view with color flow Doppler showing laminar flow in the aortic outflow cannula. Anesthesiology Clinics  , DOI: ( /j.anclin ) Copyright © 2013 Elsevier Inc. Terms and Conditions

10 Fig. 9 Pulse wave Doppler of aortic outflow cannula showing normal velocities (see text). Anesthesiology Clinics  , DOI: ( /j.anclin ) Copyright © 2013 Elsevier Inc. Terms and Conditions

11 Fig. 10 Algorithm illustrating differential diagnosis of increased pump power and echocardiographically determined decreased flow (output). Anesthesiology Clinics  , DOI: ( /j.anclin ) Copyright © 2013 Elsevier Inc. Terms and Conditions

12 Fig. 11 Algorithm illustrating differential diagnosis of decreased pump power and echocardiographically determined low or normal flow (output). Anesthesiology Clinics  , DOI: ( /j.anclin ) Copyright © 2013 Elsevier Inc. Terms and Conditions

13 Fig. 12 HeartWare LVAD in situ.
(Courtesy of Heartware, Inc, Miami Lakes, FL, USA.) Anesthesiology Clinics  , DOI: ( /j.anclin ) Copyright © 2013 Elsevier Inc. Terms and Conditions

14 Fig. 13 HeartWare LVAD in situ showing LV apical (pericardial) location of pump. (Courtesy of Heartware, Inc, Miami Lakes, Florida.) Anesthesiology Clinics  , DOI: ( /j.anclin ) Copyright © 2013 Elsevier Inc. Terms and Conditions

15 Fig. 14 Miniaturized HeartWare HVAD pump.
(Courtesy of Heartware, Inc, Miami Lakes, FL, USA.) Anesthesiology Clinics  , DOI: ( /j.anclin ) Copyright © 2013 Elsevier Inc. Terms and Conditions

16 Fig. 15 Internal view of HeartWare HVAD showing impeller.
(Courtesy of Heartware, Inc, Miami Lakes, FL, USA.) Anesthesiology Clinics  , DOI: ( /j.anclin ) Copyright © 2013 Elsevier Inc. Terms and Conditions


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