Improving Hemodynamics in Future Pump Development.pptx

1、Improving Hemodynamicsin Future Pump DevelopmentKevin Bourque,MSME,Disclosures,I am a consultant for Corvion,Inc.and BiVACOR,Inc.My presentation includes discussion generically concerning indications and devices without regulatory approval for commercial sale and distribution.,Improving hemodynamics

2、 with pumps,?,Existing devices,Future devices,+,Modified devices,Contemporary durable LVAD outcomes,Meyer D,et al.,ATS 2024,Contemporary durable LVAD outcomes,Meyer D,et al.,ATS 2024,Contemporary durable LVAD outcomes,Meyer D,et al.,ATS 2024,Meyer D,et al.,ATS 2024,Contemporary durable LVAD outcomes

3、,Contemporary durable LVAD outcomes,Contemporary durable LVAD outcomes,Grinstein J,et al.,JACC 2023,Prolongation of life strategy,“Personalized Decision-Making Between durable LVAD and Transplantation reframes the choice between durable left ventricular assist devices(LVAD)and transplantation as a d

4、ecision rooted in individual net life prolongation.“(T)his paradigm shift enables tailored strategiesparticularly for younger or lower-risk individualswhile potentially preserving transplant eligibility”,After 6 yrs on LVAD,Status 4 3.After 8 yrs on LVAD,Status 3 2.,Pathophysiology of RHF,A subset o

5、f hemodynamic aberrations prompt consideration of technological mitigation:Chronic aortic valve closure,aortic root stasis,Excessive RV preload,Altered septal geometry and function,AI/RHF interaction?Post-LVAD RH failure reduce LVP,increased transvalvular gradient AI increased RV afterload worsening

6、 RH failure.1How to address?Periodically exercise the aortic valve.Titrate LVAD therapy appropriately,i.e.,“LVAD dose”the right flow(speed)for the patient need at that time,condition,state of health,prognosis,etc.,Grinstein J,et al.,JACC 2023,Rao SD,J Card Fail 2020Oh K,et.l.,JHLT 2021Wang T,et al.,