A New 2D Echocardiographic Approach to Evaluate the Membrane and Valve Movement of the Berlin Heart EXCOR VAD Chamber in Pediatric VAD Patients

Arianna Di Molfetta, Roberta Iacobelli, Gianfranco Ferrari, Sergio Filippelli, Gianluigi Perri, Alessandra Toscano, Rachele Adorisio, Paolo Guccione, Antonio Amodeo

Research output: Contribution to journalArticle

Abstract

The use of Berlin Heart EXCOR VAD (BH) is a validated therapy to bridge pediatric patients to heart transplant. Serial echocardiographic (ECHO) assessment of VAD patients is necessary to support patients' management. This work aims at developing an innovative strategy to evaluate the BH device functioning by ECHO and its interaction with the native heart in a pediatric population. ECHO evaluation of BH membrane movement, and inflow and outflow valves was performed in 2D, 2D-color Doppler, M-mode, and M-mode color Doppler to assess the functioning of the device by direct positioning of the ECHO probe on the BH cannulas and membranes. Forty Berlin Heart EXCOR VAD were analyzed in 18 patients. Seven BH were placed as RVAD and 33 as LVAD. Results evidenced that 14 (21) inflow (outflow) valves presented a mild regurgitation, while 5 inflow (3 outflow) valves presented a moderate regurgitation. In three cases, we observed severe valve regurgitation with back flow in the left ventricle/right atrium. In both cases, the BH chambers were substituted, but we observed that in one case the regurgitation was due to cannulas compression, while in the other case it was due to valve malfunctioning. The M-mode and the ECHO of the membranes and valves permitted to appreciate the beat phenomenon to assess if the native heart and the BH are working in opposite or in the same phase. The membrane ECHO permits evaluation of minimal changes in membrane movement to assure the completely empty-completely fully work modality. Systematic ECHO assessment of BH chamber might support the BH programming and the detection of anomalous VAD-heart interaction.

Original languageEnglish
Pages (from-to)451-456
Number of pages6
JournalArtificial Organs
Volume42
Issue number4
DOIs
Publication statusPublished - Apr 2018

Fingerprint

Pediatrics
Berlin
Membranes
Color
Equipment and Supplies
Transplants
Heart Atria
Heart Ventricles
Population

Keywords

  • Child
  • Echocardiography/methods
  • Heart Atria/diagnostic imaging
  • Heart Failure/surgery
  • Heart Transplantation
  • Heart Ventricles/diagnostic imaging
  • Heart-Assist Devices/adverse effects
  • Humans
  • Prospective Studies
  • Treatment Outcome

Cite this

A New 2D Echocardiographic Approach to Evaluate the Membrane and Valve Movement of the Berlin Heart EXCOR VAD Chamber in Pediatric VAD Patients. / Di Molfetta, Arianna; Iacobelli, Roberta; Ferrari, Gianfranco; Filippelli, Sergio; Perri, Gianluigi; Toscano, Alessandra; Adorisio, Rachele; Guccione, Paolo; Amodeo, Antonio.

In: Artificial Organs, Vol. 42, No. 4, 04.2018, p. 451-456.

Research output: Contribution to journalArticle

Di Molfetta, Arianna ; Iacobelli, Roberta ; Ferrari, Gianfranco ; Filippelli, Sergio ; Perri, Gianluigi ; Toscano, Alessandra ; Adorisio, Rachele ; Guccione, Paolo ; Amodeo, Antonio. / A New 2D Echocardiographic Approach to Evaluate the Membrane and Valve Movement of the Berlin Heart EXCOR VAD Chamber in Pediatric VAD Patients. In: Artificial Organs. 2018 ; Vol. 42, No. 4. pp. 451-456.
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abstract = "The use of Berlin Heart EXCOR VAD (BH) is a validated therapy to bridge pediatric patients to heart transplant. Serial echocardiographic (ECHO) assessment of VAD patients is necessary to support patients' management. This work aims at developing an innovative strategy to evaluate the BH device functioning by ECHO and its interaction with the native heart in a pediatric population. ECHO evaluation of BH membrane movement, and inflow and outflow valves was performed in 2D, 2D-color Doppler, M-mode, and M-mode color Doppler to assess the functioning of the device by direct positioning of the ECHO probe on the BH cannulas and membranes. Forty Berlin Heart EXCOR VAD were analyzed in 18 patients. Seven BH were placed as RVAD and 33 as LVAD. Results evidenced that 14 (21) inflow (outflow) valves presented a mild regurgitation, while 5 inflow (3 outflow) valves presented a moderate regurgitation. In three cases, we observed severe valve regurgitation with back flow in the left ventricle/right atrium. In both cases, the BH chambers were substituted, but we observed that in one case the regurgitation was due to cannulas compression, while in the other case it was due to valve malfunctioning. The M-mode and the ECHO of the membranes and valves permitted to appreciate the beat phenomenon to assess if the native heart and the BH are working in opposite or in the same phase. The membrane ECHO permits evaluation of minimal changes in membrane movement to assure the completely empty-completely fully work modality. Systematic ECHO assessment of BH chamber might support the BH programming and the detection of anomalous VAD-heart interaction.",
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T1 - A New 2D Echocardiographic Approach to Evaluate the Membrane and Valve Movement of the Berlin Heart EXCOR VAD Chamber in Pediatric VAD Patients

AU - Di Molfetta, Arianna

AU - Iacobelli, Roberta

AU - Ferrari, Gianfranco

AU - Filippelli, Sergio

AU - Perri, Gianluigi

AU - Toscano, Alessandra

AU - Adorisio, Rachele

AU - Guccione, Paolo

AU - Amodeo, Antonio

N1 - © 2018 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

PY - 2018/4

Y1 - 2018/4

N2 - The use of Berlin Heart EXCOR VAD (BH) is a validated therapy to bridge pediatric patients to heart transplant. Serial echocardiographic (ECHO) assessment of VAD patients is necessary to support patients' management. This work aims at developing an innovative strategy to evaluate the BH device functioning by ECHO and its interaction with the native heart in a pediatric population. ECHO evaluation of BH membrane movement, and inflow and outflow valves was performed in 2D, 2D-color Doppler, M-mode, and M-mode color Doppler to assess the functioning of the device by direct positioning of the ECHO probe on the BH cannulas and membranes. Forty Berlin Heart EXCOR VAD were analyzed in 18 patients. Seven BH were placed as RVAD and 33 as LVAD. Results evidenced that 14 (21) inflow (outflow) valves presented a mild regurgitation, while 5 inflow (3 outflow) valves presented a moderate regurgitation. In three cases, we observed severe valve regurgitation with back flow in the left ventricle/right atrium. In both cases, the BH chambers were substituted, but we observed that in one case the regurgitation was due to cannulas compression, while in the other case it was due to valve malfunctioning. The M-mode and the ECHO of the membranes and valves permitted to appreciate the beat phenomenon to assess if the native heart and the BH are working in opposite or in the same phase. The membrane ECHO permits evaluation of minimal changes in membrane movement to assure the completely empty-completely fully work modality. Systematic ECHO assessment of BH chamber might support the BH programming and the detection of anomalous VAD-heart interaction.

AB - The use of Berlin Heart EXCOR VAD (BH) is a validated therapy to bridge pediatric patients to heart transplant. Serial echocardiographic (ECHO) assessment of VAD patients is necessary to support patients' management. This work aims at developing an innovative strategy to evaluate the BH device functioning by ECHO and its interaction with the native heart in a pediatric population. ECHO evaluation of BH membrane movement, and inflow and outflow valves was performed in 2D, 2D-color Doppler, M-mode, and M-mode color Doppler to assess the functioning of the device by direct positioning of the ECHO probe on the BH cannulas and membranes. Forty Berlin Heart EXCOR VAD were analyzed in 18 patients. Seven BH were placed as RVAD and 33 as LVAD. Results evidenced that 14 (21) inflow (outflow) valves presented a mild regurgitation, while 5 inflow (3 outflow) valves presented a moderate regurgitation. In three cases, we observed severe valve regurgitation with back flow in the left ventricle/right atrium. In both cases, the BH chambers were substituted, but we observed that in one case the regurgitation was due to cannulas compression, while in the other case it was due to valve malfunctioning. The M-mode and the ECHO of the membranes and valves permitted to appreciate the beat phenomenon to assess if the native heart and the BH are working in opposite or in the same phase. The membrane ECHO permits evaluation of minimal changes in membrane movement to assure the completely empty-completely fully work modality. Systematic ECHO assessment of BH chamber might support the BH programming and the detection of anomalous VAD-heart interaction.

KW - Child

KW - Echocardiography/methods

KW - Heart Atria/diagnostic imaging

KW - Heart Failure/surgery

KW - Heart Transplantation

KW - Heart Ventricles/diagnostic imaging

KW - Heart-Assist Devices/adverse effects

KW - Humans

KW - Prospective Studies

KW - Treatment Outcome

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DO - 10.1111/aor.13122

M3 - Article

VL - 42

SP - 451

EP - 456

JO - Artificial Organs

JF - Artificial Organs

SN - 0160-564X

IS - 4

ER -