This goal of this study is to analyze images of the right ventricle taken via 3D transesophageal echocardiography (TEE) during left ventricular assist device (LVAD) implantation.
There are two chambers in the heart known as ventricles which are responsible for pumping blood to both the lungs and the rest of the body. The right ventricle pumps blood to the lungs for oxygenation. The left ventricle then delivers this oxygenated blood to the organs in the body. When the left ventricle is damaged enough that it is not able to effectively pump blood then it may be necessary to assist it with a mechanical pump. This pump is called left ventricular assist device (LVAD). Left ventricular assist devices (LVADs) improve quality of life and survival in patients with end stage heart failure. However, right ventricular (RV) failure is common in 20-50% of LVAD recipients and is associated with perioperative complications. Traditional two-dimensional ultrasound views of the right ventricle may not accurately depict how well or poorly the right ventricle is working. Three-dimensional (3D) images can overcome the limitations of two-dimensional images and are becoming more commonplace. This goal of this study is to analyze images of the right ventricle taken via 3D transesophageal echocardiography (TEE) during the LVAD implantation to help predict which patients are at higher risk of right ventricular failure within 14 days of the procedure.
Study Type
OBSERVATIONAL
Enrollment
200
Mazankowski Alberta Heart Institute
Edmonton, Alberta, Canada
RECRUITINGLeft ventricular strain
Prognostic indicator of hypertensive heart failure
Time frame: 24 hours
Right ventricular fractional area of change
Percentage change in the RV chamber area between end-diastole to end-systole
Time frame: 24 hours
Right ventricular free wall strain
Prognostic indicator of pulmonary arterial hypertension
Time frame: 24 hours
Right ventricular end diastolic volume
Amount of blood in the heart's right ventricle just before the heart contracts
Time frame: 24 hours
Light ventricular end diastolic volume
Amount of blood in the heart's left ventricle just before the heart contracts
Time frame: 24 hours
Right ventricular end systolic volume
Amount of blood in the heart's right ventricle just after the heart contracts
Time frame: 24 hours
Left ventricular end systolic volume
Amount of blood in the heart's left ventricle just after the heart contracts
Time frame: 24 hours
Right ventricular ejection fraction
Amount of blood being pumped out of the right ventricle each time it contracts.
Time frame: 24 hours
Left ventricular ejection fraction
Amount of blood being pumped out of the left ventricle each time it contracts.
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Time frame: 24 hours
Tricuspid annular plane systolic excursion
Parameter of global right ventricular function
Time frame: 24 hours
Age
Demographic measure
Time frame: 1 day
Gender
Demographic measure
Time frame: 1 day
Body Surface Area
Demographic measure
Time frame: 1 day
Central venous pressure
Pressure in the thoracic vena cava near the right atrium
Time frame: 14 days
Pulmonary artery pulsatility index
Hemodynamic index
Time frame: 14 days
Need for right ventricular mechanical support
Circulatory support
Time frame: 14 days
Need for pulmonary vasodilators
Supportive medication
Time frame: 14 days
Need for vasopressors
Supportive medications
Time frame: 14 days
Aspartate aminotransferase
Lab test (\> or qual to 80 IU/L)
Time frame: 14 days
Bilirubin
Lab test (\> 2.0 mg/dL)
Time frame: 14 days
Creatinine
Lab test (\> or equal to 2.3 mg/dL)
Time frame: 14 days