Week 2- Grant Rowlands

The majority of my week was spent in clinic and rounding to see VAD patients who were recently implanted with a HeartMate 3 as a bridge to transplant or destination therapy. The image on the left shows a typical HM3 implant where the pump is inserted into the apex of the heart and an outflow graph is sutured to the aortic arch. Two patients were indicated for destination therapy (meaning long-term support) as they were ineligible for full cardiac transplant due to pre-existing conditions. These patients were recovering well and were expected to be discharged in the near future (~ 1 week).  

One patient who received a HM3 on Monday was in critical condition in the cardiac intensive care unit. This patient needed to be supported on both the left side and right of the heart to maintain peripheral perfusion to the rest of the body. The image on the right shows a heart with mechanical circulatory support on the left sight of the heart (LVAD) and a Centrimag pump on the right side of the heart (RVAD).  The Centrimag is a small extracorporeal pump which assists supports the right portion of the heart which supplies the lungs.

My research topic has been narrowed down to identifying indicators that may predict right heart failure. Although there have been significant strides recently in the VAD space such as mitigating pump thrombosis and stroke, right heart failure remains a significant issue and must be addressed in the future. I will be working with medical students and residents to predict trends in this space.