It is your first night as a resident in the cardiothoracic intensive care unit.

Question

It is your first night as a resident in the cardiothoracic intensive care unit. A patient with severe biventricular systolic failure has just come out of the operating room, where both a left ventricular assist device (LVAD) and right ventricular assist device (RVAD) were implanted in their heart. When the attending physician comes in the morning you get berated, as it appears the patient has developed pulmonary edema overnight while you weren't paying attention. Which of the following factors could have caused this? I More output from the LVAD than the RVAD Il More output from the RVAD than the LVAD Ill Aortic valve insufficiency ("leakiness") with LVAD output-RVAD output IV Pulmonary valve insufficiency ("leakiness") with LIAD output=RVAD output I and lI Ill and IV I and IV Il and III l, lll, lll,

Explanation / Answer

II and III - More output from RAVD than LAVD and aortic valve insufficiency

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