Importance of Pulsatility in Left Ventricular Assist Device

M. Hieda, T. Maruyama

Abstract: A left ventricular assist device (LVAD) can improve the quality of life and mortality in those patients. Continuous-flow LVAD has unique physiology characterized by a non- (or weak-) pulsatile and non-laminar blood flow profile without the Wind-Kessel effect during diastole. Unfortunately, many LVAD-related adverse events are associated with long-term mortality in patients with the current generation of LVADs, even in the current Heartmate 3 era. In addition, LVAD patients without pulsatility have a high incidence of hemocompatibility complications, including gastrointestinal bleeding, pump thrombosis, and stroke. From the point of view of clinical hemorheology, this review covers the clinical importance of pulsatility and hemocompatibility-related adverse events associated with a reduction in pulsatility in patients with LVAD. Understanding these hemodynamic changes with LVADs may provide clinical pearls for improving patients' outcomes. Indeed, the modulation of pulsatility may serve as a novel strategy for reducing complications.

Series on Biomechanics, Vol.36 No.2 (2022), 28-37
DOI: 10.7546/SB.36.2022.02.03

Keywords: hemocompatibility; Left ventricular assist device; pulsatility

Date published: 2022-06-17