Evaluation of the effects of the ratio of device volume to body surface area on systemic perfusion in patients with implanted left ventricular assist devices

This study was conducted to evaluate whether a new index value obtained by the ratio of the cardiac output provided by the LVAD device to the body surface area is effective in perfusion. The relationship between the VAD index and perfusion was evaluated with laboratory values and clinical parameters. Patients who underwent left ventricular assist device implantation by Akdeniz University Faculty of Medicine, Department of Cardiovascular Surgery between 13/09/2022-12/09/2023 were included in the study. Data were obtained from the Akdeniz University Faculty of Medicine Hospital Database, Electronic Patient Files, Epicrisis Forms, Laboratory Results and anamnesis of the patients. Age, gender, DM, PAH, HT, presence of ICMP in etiology, per-op EF, Furosemide use, hospitalization due to heart failure symptoms in the last 6 months and LDH, BUN, Creatinine, AST, ALT values were used. The liter and watt values of the device and the VAD index obtained according to the ratio of device liter to body surface area were among the study data. Data were analyzed using SPSS 23.0 program. For descriptive statistics, number and percentage values were used for categorical variables, and mean, standard deviation and minimum- maximum values were used for continuous variables. The conformity of the data to normal distribution was checked by Kolmogorov-Smirnov and Shapiro-Wilk Test. T Test, Mann-Whitney U Test, Chi-square test and Repeated Measures Analysis of Variance Test were used to compare the groups. Statistical significance level was accepted as p<0,05. Of the 35 patients in the study, 54% used Heartware and 46% used Heartmate-3. 88,6% of all patients were male. The prevalence of DM and PAH was 28,6% and the prevalence of HT was 51,4% in all patients using LVAD devices. There were no time-dependent differences in liter and VAD index values and laboratory values measured at different times. VAD Index values were lower in patients with hospitalization compared to those without hospitalization. In the study, patients with lower VAD Index values required higher doses of Furosemide. There was a statistically significant difference in LDH values according to VAD index groups, while there was no statistically significant difference in LDH values according to liter groups. Those with a VAD Index value of 1,86 and below had higher LDH values than the higher group. LVAD devices are among the current topics that benefit quality of life and survival in heart failure patients. Studies involving more patients with different variables or new index values are needed. Follow-up and improvement of LVAD device performance measurements will provide significant benefit for patients with advanced heart failure.