Comparative Studies of Axial Ventricular Assist Devices (VAD) and the Effect of Outflow Cannulation

2013 ◽  
Author(s):  
Wei-Che Chiu ◽  
Yared Alemu ◽  
Bryan Lynch ◽  
Shmuel Einav ◽  
Marvin Slepian ◽  
...  
Keyword(s):  
Heart Failure ◽  
The United States ◽  
Ventricular Assist Devices ◽  
Circulatory Support ◽  
Ventricular Assist ◽  
Assist Devices ◽  
High Incidence ◽  
Mechanical Circulatory Support Devices ◽  
Compact Design ◽  
Blood Flow Patterns

Congestive heart failure has reached epidemic proportions in the United States with more than 5.7 million patients suffering from it annually ( 1). Due to the limited availability of donor hearts, patients in their late stage heart failure who may require cardiac transplantation are dying while waiting for a matched heart. Mechanical circulatory support devices (MCS), such as ventricular assist devices (VAD), are utilized as a bridge to transplantation, and recently as destination therapy for extending the life of these patients. Continuous-flow VAD offer a surgical advantage over older generation pulsatile-flow VAD due to their compact design; however, due to the high RPM these VADs are operated with and the non-physiological blood flow patterns they generates, VADs are burdened with high incidence of thromboembolic events, and antiplatelet/anticoagulation regimens are mandated for the device recipients.

Development of Mechanical Circulatory Support Devices: 55 Years and Counting

2021 ◽  
Vol 32 (4) ◽  
pp. 424-433
Author(s):  
Emalie Petersen
Keyword(s):  
Mechanical Circulatory Support ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Circulatory Support ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Assist Devices ◽  
Left Ventricular Assist ◽  
Mechanical Circulatory Support Devices ◽  
Support Devices

Heart failure is a leading cause of morbidity and mortality in the United States. Treatment of this condition increasingly involves mechanical circulatory support devices. Even with optimal medical therapy and use of simple cardiac devices, heart failure often leads to reduced quality of life and a shortened life span, prompting exploration of more advanced treatment approaches. Left ventricular assist devices constitute an effective alternative to cardiac transplantation. These devices are not without complications, however, and their use requires careful cooperative management by the patient’s cardiology team and primary care provider. Left ventricular assist devices have undergone many technological advancements since they were first introduced, and they will continue to evolve. This article reviews the history of different types of left ventricular assist devices, appropriate patient selection, and common complications in order to increase health professionals’ familiarity with these treatment options.

scholarly journals Current Trends in Implantable Left Ventricular Assist Devices

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Jens Garbade ◽  
Hartmuth B. Bittner ◽  
Markus J. Barten ◽  
Friedrich-Wilhelm Mohr
Keyword(s):  
Heart Failure ◽  
Selection Process ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Circulatory Support ◽  
Destination Therapy ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Assist Devices ◽  
Left Ventricular Assist

The shortage of appropriate donor organs and the expanding pool of patients waiting for heart transplantation have led to growing interest in alternative strategies, particularly in mechanical circulatory support. Improved results and the increased applicability and durability with left ventricular assist devices (LVADs) have enhanced this treatment option available for end-stage heart failure patients. Moreover, outcome with newer pumps have evolved to destination therapy for such patients. Currently, results using nonpulsatile continuous flow pumps document the evolution in outcomes following destination therapy achieved subsequent to the landmark Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure Trial (REMATCH), as well as the outcome of pulsatile designed second-generation LVADs. This review describes the currently available types of LVADs, their clinical use and outcomes, and focuses on the patient selection process.

Thrombogenicity Comparison of Axial Ventricular Assist Devices by DTE Methodology: MicroMed HeartAssist 5 and Thoratec Heartmate II

2012 ◽  
Author(s):  
Wei-Che Chiu ◽  
Michalis Xenos ◽  
Yared Alemu ◽  
Gaurav Girdhar ◽  
Bryan Lynch ◽  
...  
Keyword(s):  
Severe Heart Failure ◽  
Ventricular Assist Devices ◽  
Heartmate Ii ◽  
Ventricular Assist ◽  
Assist Devices ◽  
Life Saving ◽  
High Incidence ◽  
Organ Donations ◽  
Hemodynamic Performance ◽  
Compact Design

Mechanical circulatory devices, such as ventricular assist devices (VADs), have become the life-saving alternative for the patients who suffered from severe heart failure (1). These devices were utilized as the bridge-transplant devices; however, due to the fast growing population of cardiovascular diseases and the eligible organ donations are very limited, these devices have been considered for the application of life-long implantation. The continuous-flow VADs offer better hemodynamic performance than the first generations pulsatile flow VADs, its compact design offers surgical advantage; however, due to the non-physiological blood flow past constricted geometrics where platelets are exposed to elevated wall shear stress (2), VADs are burdened with high incidence of thromboembolic events, mandating anticoagulation therapies for its recipients (3).

Outcome for children following admission to hospital with a first episode of heart failure, due to heart muscle disease, in the ventricular assist device (VAD) era

2019 ◽  
Vol 29 (7) ◽  
pp. 888-892
Author(s):  
Andres Rico-Armada ◽  
David S. Crossland ◽  
Louise Coats ◽  
Zdenka Reinhardt ◽  
Anthony Hermuzi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Muscle ◽  
Recovery Of Function ◽  
Muscle Disease ◽  
Ventricular Assist Devices ◽  
Circulatory Support ◽  
First Episode ◽  
Assist Device ◽  
Ventricular Assist ◽  
Assist Devices

AbstractAims:Most reports on the outcome of children who present with heart failure, due to heart muscle disease, are from an era when ventricular assist devices were not available. This study provides outcome data for the current era where prolonged circulatory support can be considered for most children.Methods & Results:Data was retrieved on 100 consecutive children, who presented between 2010 – 2016, with a first diagnosis of unexplained heart failure. Hospital outcome was classified as either death, transplantation, recovery of function or persistent heart failure. Median age at presentation was 24 months and 58% were < 5 years old. Hospital mortality was 12% and 59% received a heart transplant. Most, 79%, of the transplants were carried out on patients with a device. Recovery of function was observed in 18% and 10% stabilised on oral therapy. Eighty-four percent of the deaths occurred in the <5 year old group. Shorter duration of support was associated with survival (34 days in survivors versus 106 in non-survivors, p = 0.01) and 72% were on an assist device at time of death.Conclusion:Heart failure in children who require referral to a transplant unit is a serious illness with a high chance of either transplantation or death. Modifications in assist devices will be required to improve safety, especially for children < 5 years old where the donor wait may be prolonged. The identification of children who may recover function requires further study.

Anesthetic Management for Patients With Left Ventricular Assist Devices Undergoing Noncardiac Surgery

2019 ◽  
pp. 137-145
Author(s):  
Amanda M. Kleiman ◽  
Christopher Spencer ◽  
Julie L. Huffmyer
Keyword(s):  
Heart Failure ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Circulatory Support ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Assist Devices ◽  
Left Ventricular Assist ◽  
Anesthetic Considerations ◽  
Altered Physiology

The incidence and prevalence of chronic heart failure is increasing in the United States, and end-stage heart failure is associated with high mortality. While medical management is often the first-line treatment of heart failure, mechanical circulatory support and ventricular assist device therapies are being increasingly employed to improve symptoms and end-organ dysfunction from heart failure. Patients with left ventricular assist devices (LVADs) are not only surviving with their disease, but also thriving as a result of LVAD support, and many return to normal activities of daily life. Thus, these patients present to hospitals for noncardiac surgeries, both elective and urgent, with increasing frequency. This chapter explores some commonly used ventricular assist devices, the altered physiology that accompanies LVAD therapy with continuous flow devices, as well as some of the anesthetic considerations that are vital for patients presenting for both elective and urgent surgeries.

scholarly journals Physical Therapist Management of Patients With Ventricular Assist Devices: Key Considerations for the Acute Care Physical Therapist

2013 ◽  
Vol 93 (2) ◽  
pp. 266-278 ◽  
Author(s):  
Chris L. Wells
Keyword(s):  
Heart Failure ◽  
Acute Care ◽  
Physical Therapist ◽  
The United States ◽  
Functional Mobility ◽  
Ventricular Assist Devices ◽  
Rehabilitation Services ◽  
Ventricular Assist ◽  
Assist Devices

This article provides an overview of the utilization of ventricular assist devices (VADs), reviews the common features of VADs and management of VAD recipients, discusses clinical considerations in the rehabilitation process, and describes the role of the acute care physical therapist in the care of VAD recipients. With more than 5 million people in the United States with heart failure, and with a limited ability to manage the progressive and debilitating nature of heart failure, VADs are becoming more commonplace. In order to prescribe a comprehensive and effective plan of care, the physical therapist needs to understand the type and function of the VADs and the goals of the VAD program. The goals for the physical therapist are: (1) to deliver comprehensive rehabilitation services to patients on VAD support, (2) to develop an understanding of the role of functional mobility in recovery, and (3) to understand how preoperative physical function may contribute to the VAD selection process. The acute care physical therapist has an increasing role in providing a complex range of rehabilitation services, as well as serving as a well-educated resource to physical therapists across the health care spectrum, as more VAD recipients are living in the community.

Ventricular Assist Devices

2012 ◽  
Vol 23 (1) ◽  
pp. 69-83 ◽  
Author(s):  
Genevieve O’Shea
Keyword(s):  
Heart Failure ◽  
Ventricular Assist Device ◽  
Advanced Heart Failure ◽  
Ventricular Assist Devices ◽  
Circulatory Support ◽  
Nursing Management ◽  
Assist Device ◽  
Physiological Basis ◽  
Ventricular Assist ◽  
Assist Devices

Patients with advanced heart failure have limited treatment options despite advances in medical management. Ventricular assist devices represent a surgical option that offers improved end-organ function, survival, and quality of life. Postoperative nursing management involves the most complicated aspects of care following cardiac surgery as well as issues unique to advanced heart failure and mechanical circulatory support. Despite growing numbers of ventricular assist device implants, literature about the challenging care of patients following ventricular assist device implantation is limited. This article focuses on the physiological basis for postoperative nursing management strategies and the most important complications of which critical care nurses need to be aware.

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