Fundus Fluorescein Angiographic Findings in Patients Who Underwent Ventricular Assist Device Implantation

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dc.contributor.authorOzturk, Taylan
dc.contributor.authorNalcaci, Serhad
dc.contributor.authorOzturk, Pelin
dc.contributor.authorEngin, Cagatay
dc.contributor.authorYagdi, Tahir
dc.contributor.authorAkkin, Cezmi
dc.contributor.authorOzbaran, Mustafa
dc.date.accessioned2019-10-27T22:08:29Z
dc.date.available2019-10-27T22:08:29Z
dc.date.issued2013
dc.departmentEge Üniversitesien_US
dc.description.abstractDisruption of microcirculation in various tissues as a result of deformed blood rheology due to ventricular assist device (VAD) implantation causes novel arteriovenous malformations. Capillary disturbances and related vascular leakage in the retina and choroidea may also be seen in patients supported by VADs. We aimed to evaluate retinal vasculature deteriorations after VAD implantation. The charts of 17 patients who underwent VAD implantation surgery for the treatment of end-stage heart failure were retrospectively reviewed. Eight cases (47.1%) underwent pulsatile pump implantation (Berlin Heart EXCOR, Berlin Heart Mediprodukt GmbH, Berlin, Germany); however, nine cases (52.9%) had continuous-flow pump using centrifugal design (HeartWare, HeartWare Inc., Miramar, FL, USA). Study participants were selected among the patients who had survived with a VAD for at least 6 months, and results of detailed ophthalmologic examinations including optic coherence tomography (OCT) and fundus fluorescein angiography (FA) were documented. All of the 17 patients were male, with a mean age of 48.5 +/- 14.8 years (15-67 years). Detailed ophthalmologic examinations including the evaluation of retinal vascular deteriorations via FA were performed at a mean of 11.8 +/- 3.7 months of follow-up (6-18 months). Mean best-corrected visual acuity and intraocular pressure were found as logMAR 0.02 +/- 0.08 and 14.6 +/- 1.9mmHg, respectively in the study population. Dilated fundoscopy revealed severe focal arteriolar narrowing in two patients (11.8%), and arteriovenous crossing changes in four patients (23.5%); however, no pathological alteration was present in macular OCT scans. In patients with continuous-flow blood pumps, mean arm-retina circulation time (ARCT) and arteriovenous transit time (AVTT) were found to be 16.8 +/- 3.0 and 12.4 +/- 6.2s, respectively; whereas those with pulsatile-flow blood pumps were found to be 17.4 +/- 3.6 and 14.0 +/- 2.1s in patients (P=0.526 and P=0.356, respectively). FA also revealed a tendency for increased frequency of dye leakage from the optic disc in our study population. Except for remarkable delays in both ARCT and AVTT as well as a tendency for increased frequency of dye leakage from the optic disc, ophthalmologic evaluations revealed no other significant pathology or vascular deterioration in the retina that could be attributed to artificial heart systems.en_US
dc.identifier.doi10.1111/aor.12123en_US
dc.identifier.endpage820en_US
dc.identifier.issn0160-564X
dc.identifier.issue9en_US
dc.identifier.pmid23826834en_US
dc.identifier.startpage816en_US
dc.identifier.urihttps://doi.org/10.1111/aor.12123
dc.identifier.urihttps://hdl.handle.net/11454/49189
dc.identifier.volume37en_US
dc.identifier.wosWOS:000325082500012en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherWiley-Blackwellen_US
dc.relation.ispartofArtificial Organsen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectVentricular assist deviceen_US
dc.subjectMechanical circulatory supporten_US
dc.subjectFluorescein angiographyen_US
dc.subjectEyeen_US
dc.subjectRetinaen_US
dc.subjectOphthalmologic disordersen_US
dc.titleFundus Fluorescein Angiographic Findings in Patients Who Underwent Ventricular Assist Device Implantationen_US
dc.typeArticleen_US

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