PURPOSE: 

• The purpose of this study is to assess the utility of nitric oxide for inhalation as an elective pulmonary vasodilator in treating pulmonary hypertension during left ventricular assist device (LVAD) placement. 

BACKGROUND: 

• Nitric Oxide (NO) increases the partial pressure of arterial oxygen (PO2) by acting as a selective pulmonary vasodilator. 
• NO promotes ventilation in poorly ventilated lung regions, thus improving ventilation-perfusion matching. 
• Congestive Heart Failure (CHF) can cause progressive left ventricular failure.  To support patients with long standing left ventricular failure and low cardiac output, a left ventricular assist device (LVAD) can be inserted. 
• Insertion of these mechanical devices often uncovers and may even create new problems.  If pulmonary hypertension is not yet clinically evident, CHF patients can develop it intra-operatively during LVAD placement. 
• NO may be a useful adjunct when pulmonary hypertension limits LVAD device filling and output.  NO is not approved for use in adults.

CRITERIA FOR INCLUSION: 

• ≥ 18 years old and scheduled to undergo first elective LVAD implantation.

CRITERIA FOR EXCLUSION:   

• Elective Biventricular Assist Device (BiVAD) surgery, received NO by inhalation therapy or other investigational drug within the past 24 hours, and pregnancy.

RECRUITMENT OF SUBJECTS: 

• Subjects will be recruited by the clinic at Aston Ambulatory Care Center and St. Paul University Hospital. 

For more information, please contact Nicklett Johnston, R.N. at 214-645-7728.