Mechanical Support of the Failing Heart

Mechanical Support of the Failing Heart is a topic covered in the Pocket ICU Management.

To view the entire topic, please or purchase a subscription.

Anesthesia Central is an all-in-one web and mobile solution for treating patients before, during, and after surgery. This collection of drug, procedures and test information is derived from Davis’s Drug, MGH Clinical Anesthesia Procedures, Pocket Guide to Diagnostic Tests, and MEDLINE Journals. Explore these free sample topics:

Anesthesia Central

-- The first section of this topic is shown below --

First Things First

  • Indications for mechanical support: NYHA class IV heart failure secondary to ischemic or non-ischemic cardiomyopathy (viral, peripartum, alcoholic, infiltrative)
  • What is accomplished by providing mechanical support? Offloads the failed ventricle, allows time for recovery, supports end organs
  • What options are available? Pulsatile and non-pulsatile (axial flow) devices exist, and best individual fit is determined by a combination of size, durability, and etiology of heart failure.
  • Which physiologic parameters are controlled by the device?
    • Pump output = pump rate x pump stroke volume
      • Pump rate may be adjusted by changing pump frequency (pulsatile) or revolutions per minute (axial flow).
      • Stroke volume (or equivalent) may be adjusted by adding vacuum to pulsatile devices or adjusting afterload for axial flow devices.
    • CO = HR x SV
  • Which physiologic parameters can be controlled medically or pharmacologically? Preload, pulmonary vascular resistance, native heart rhythm, systemic vascular resistance, native heart contractility

-- To view the remaining sections of this topic, please or purchase a subscription --

Last updated: May 8, 2010