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L Schmetterer, E Polska, G Wieselthaler, H Schima; Ocular Microcirculation in Patients With Rotary Cardiac Assist Devices . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3301.
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Purpose:Little is known about microcirculatory conditions in peripheral organs in patients with low pulsatile cardiac assist devices. This issue is most critical in organs with constant oxygen requirements such as the brain or the eye. Methods:In 3 male patients with rotary pumps (Micromed) the pulsatile component of choroidal blood was assessed with laser interferometric measurement of fundus pulsation amplitude (FPA) and choroidal blood flow was measured with laser Doppler flowmetry. Pump velocity was adjusted to 4 levels of flow between individual minimal need and maximal support. Results:At decreasing pump support FPA increased by 22 to 35%. At maximal support FPA was strongly reduced by 85 to 142% compared to minimal support. Blood flow in the choroidal microvasculature did, however, not show relevant changes (< 20%). Conclusion:Our data indicate that mean choroidal blood flow is maintained when pump support is varied within therapeutic values, whereas the ratio of pulsatile to non-pulsatile choroidal flow changes. Concluding, this study shows that in patients with ventricular assist devices a normal perfusion rate in the ocular microcirculation is maintained over a wide range of conditions.
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