Novel Formula to Calculate Three-Dimensional Angle Between Inflow Cannula and Device Body of HeartMate II LVAD.


Journal

The Annals of thoracic surgery
ISSN: 1552-6259
Titre abrégé: Ann Thorac Surg
Pays: Netherlands
ID NLM: 15030100R

Informations de publication

Date de publication:
01 2020
Historique:
received: 10 01 2019
revised: 09 04 2019
accepted: 30 04 2019
pubmed: 1 7 2019
medline: 24 4 2020
entrez: 1 7 2019
Statut: ppublish

Résumé

The acute angle between inflow cannula and device body of HeartMate II left ventricular assist device (LVAD) (Abbott, Pleasanton, California) is associated with device thrombosis. However, most studies utilized two-dimensional (2D) angle obtained from chest roentgenogram (CXR), which is unlikely accurate. We aimed to create and validate a formula to estimate actual three-dimensional (3D) angle. We retrospectively reviewed the cohort undergoing HeartMate II LVAD implantation between 2008 and 2016. A formula for calculating 3D angles of the LVAD inflow cannula relative to the device body was mathematically derived, using simple 2D measurements from CXR. The cohort included consecutive 275 patients with HeartMate II (median age: 60 [25% quartile: 51, 75% quartile: 68] years). There was no significant difference between the calculated 3D angles (from formula) and actual 3D angles (from computed tomography) from the subset group with 3D computed tomography (n = 28) (71.7° ± 13.4° vs 71.1° ± 11.5°, P = .858). Among all participants, the calculated 3D angle (from formula) was 74.4° ± 14.2°, which was significantly larger than the 2D projected angle (from CXR) (65.2° ± 11.3°, P < .001). There was no statistical difference in the calculated 3D angles (from formula) between patients with/without device thrombosis, hemorrhagic stroke, ischemic stroke, or mortality (P > .05 for all). We established a novel formula to mathematically calculate actual 3D angles between inflow cannula and device body of HeartMate II. The formula would help investigators to validate their findings of the relationship between 2D projected angle (from CXR) and device thrombosis.

Sections du résumé

BACKGROUND
The acute angle between inflow cannula and device body of HeartMate II left ventricular assist device (LVAD) (Abbott, Pleasanton, California) is associated with device thrombosis. However, most studies utilized two-dimensional (2D) angle obtained from chest roentgenogram (CXR), which is unlikely accurate. We aimed to create and validate a formula to estimate actual three-dimensional (3D) angle.
METHODS
We retrospectively reviewed the cohort undergoing HeartMate II LVAD implantation between 2008 and 2016. A formula for calculating 3D angles of the LVAD inflow cannula relative to the device body was mathematically derived, using simple 2D measurements from CXR.
RESULTS
The cohort included consecutive 275 patients with HeartMate II (median age: 60 [25% quartile: 51, 75% quartile: 68] years). There was no significant difference between the calculated 3D angles (from formula) and actual 3D angles (from computed tomography) from the subset group with 3D computed tomography (n = 28) (71.7° ± 13.4° vs 71.1° ± 11.5°, P = .858). Among all participants, the calculated 3D angle (from formula) was 74.4° ± 14.2°, which was significantly larger than the 2D projected angle (from CXR) (65.2° ± 11.3°, P < .001). There was no statistical difference in the calculated 3D angles (from formula) between patients with/without device thrombosis, hemorrhagic stroke, ischemic stroke, or mortality (P > .05 for all).
CONCLUSIONS
We established a novel formula to mathematically calculate actual 3D angles between inflow cannula and device body of HeartMate II. The formula would help investigators to validate their findings of the relationship between 2D projected angle (from CXR) and device thrombosis.

Identifiants

pubmed: 31255615
pii: S0003-4975(19)30895-1
doi: 10.1016/j.athoracsur.2019.04.124
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

63-68

Informations de copyright

Copyright © 2020 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Auteurs

Yasuyuki Tsushima (Y)

Graduate School of Medicine, University of Tokyo, Tokyo, Japan.

Teruhiko Imamura (T)

Department of Medicine, University of Chicago Medical Center, Chicago, Illinois.

Luis Landeras (L)

Department of Radiology, University of Chicago Medical Center, Chicago, Illinois.

Hiroto Kitahara (H)

Department of Surgery, University of Chicago Medical Center, Chicago, Illinois.

Wataru Gonoi (W)

Department of Radiology, Graduate School of Medicine, The University of Tokyo, Japan.

Gabriel Sayer (G)

Department of Medicine, University of Chicago Medical Center, Chicago, Illinois.

Nir Uriel (N)

Department of Medicine, University of Chicago Medical Center, Chicago, Illinois.

Valluvan Jeevanandam (V)

Department of Surgery, University of Chicago Medical Center, Chicago, Illinois.

Takeyoshi Ota (T)

Department of Surgery, University of Chicago Medical Center, Chicago, Illinois. Electronic address: tota@bsd.uchicago.edu.

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