Impact of Reduced Pulsatility on End-organs with Continuous Flow LVAD Support by Prof Chris Hayward & A/Prof Kavitha Muthiah

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Heart failure affects a significant portion of the Australian population, with an estimated 325,000 patients grappling with this condition.  Among these patients, those with refractory heart failure often find relief in continuous flow left ventricular assist devices (cfLVADs) as a bridge to transplantation.  Globally, over 25,000 individuals have been supported with cfLVADs, with implantation rates surpassing 3,000 patients annually and continuing to rise.  However, while these devices offer a lifeline, they come with their own set of challenges.

One notable challenge associated with cfLVAD support is the lack of pulsatility in blood flow.  Unlike a healthy heart, which generates pulsatile blood flow, cfLVADs operate at a constant pump speed, resulting in diminished blood pressure pulsatility and flow variability throughout the body.  Research suggests that increased pulsatility is associated with better outcomes, prompting Prof Chris Hayward and A/Prof Kavitha Muthiah to explore further the implications of this altered blood flow pattern on end organs.

This study, supported by the St Vincent’s Clinic Research Foundation (SVCRF), aims to characterize blood flow in major organs and vessels, shedding light on the physiological changes and potential new blood vessel formation resulting from reduced pulsatility.  By gaining a comprehensive understanding of these alterations, we can identify strategies to mitigate associated risks and enhance patient outcomes while informing the development of future pump designs.

“Thanks to the support provided by SVCRF, significant strides have been made in understanding the impact of the differences in blood circulation in small vessels.  These findings underscore the importance of pulsatility in organ function, particularly with the latest generation of mechanical heart pumps.” Prof Chris Hayward