Abstract
Although clinical experience showed the effectiveness of LVAD for maintaining systemic flow and pressure on postcardiotomy cardiogenic shock patients, renal insufficiency might likely progress when the right atrial pressure (RAP) was high. The influence of increased venous pressure on renal circulation and function was studied using eight adult mongrel dogs. An occlusion balloon catheter was applied selectively in left renal vein to obtain high renal vein pressure (RVP), simulating clinical settings of high RAP with normal blood pressure (BP) and cardiac output (CO). Renal blood flow, urine output and free water clearance of left kidney (RVP=25.1±1.6mmHg) were significantly lower than those of right kidney (RVP=2.6±0.7mmHg), despite of normal BP and CO. To avoid the progression of renal insufficiency, early application of RVAD would be useful for the patient who is supported by LVAD and has high RAP.
