By A. Misra
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Etiology: fate of CHF patients with severe right ventricular (RV) failure (CVP>16mmHg) is worse, compared with those patients with left heart sided pathologies. Current therapies employing CAD to treat CHF patients with severe RV failure (Prutkin et al. 2008), still exhibit a high mortality rate (65%-95%), most probably due to insufficient understanding of the great difference between the right and left heart circuits (Sollano, 1998). c. Preclinical studies: in particular, the role of animal models in therapeutic evaluation, which is an extremely essential procedure before proceeding to clinical “Flow and Rate”: Concept and Clinical Applications of a New Hemodynamic Theory d.
Most probably, CAD may aggravate hemodynamics, leading to multiple organ failure and death due to several factors that could be directly linked to devices themselves or indirectly due to patients’ related factors as follows: 1. Devices related factors: a. Concept and design: a CAD is typically a lumped model constructed according to laws of physics for driving a Newtonian compressible fluid inside a closed pressurized hydraulic circuits (Roselli RJ & Brophy, 2003), implementing rigid tubes with fixed diameter.
Left heart postnatal remodeling zones LV= left ventricle. 2. The right heart circuit: contrarily to the left, the right heart could adjust blood volume and shear rates at 5 different anatomical zones according to its physiological demands. In antenatal period, the right heart receives and pumps in equal rates more volume than the left, but keeps low remodeling due to pressure release through physiological shunts (Clark, 1987). After birth and shunts closure, both right and left ventricles share equal volume and rate inducing equal pulmonary and systemic cardiac output (CO), but remodeling remains inferior at the right heart side most probably due to venous steady flow and ventricular wall trabeculae.