Time
spent in the clinic this week focused on the condition of a patient supported
for both right and left heart failure (as described in previous blogs). Unfortunately,
the patient’s condition has not improved and continues to be on a ventilator.
The heart failure team has been incorporating hemodynamic techniques in an
attempt to improve the patient’s viability. Measures undertaken included decreasing
the flow rate of the LVAD to reduce suction and weaning off of the RVAD as the
right ventricle has been unloaded successfully. Unfortunately, the patient is
now experience renal failure, and their prognosis continues to decline.
The remainder
of my week was spent in San Francisco at the ASAIO Conference (formerly
American Society of Artificial Internal Organs). The conference has been
extremely informative as many engineers and doctors have been presenting and
exploring the issues plaguing the mechanical circulatory support space. One
panel talk discussed how adverse events (bleeding, stroke, pump thrombosis)
should be reported; the panelists argue there are inconsistent definitions and
it makes extremely difficult to clearly define these challenges. Although design
of the pump is important, management of the patient sometimes gets lost in translation—every
patient presents new challenges. I was also fortunate enough to present some of
my research in a poster titled “High-Speed Visualization of Ingested and
Ejected Red Thrombus from the HeartMate II Left Ventricular Assist Device”,
which received positive remarks from conference-goers.
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