Invasive Haemodynamic Assessment Before and After Left Ventricular Assist Device Implantation: A Guide to Current Practice

Left Ventricular ◽

Circulatory Support ◽

Assist Device ◽

Ventricular Assist ◽

Right Heart Catheterisation ◽

Mechanical circulatory support for the management of advanced heart failure is a rapidly evolving field. The number of durable long-term left ventricular assist device (LVAD) implantations increases each year, either as a bridge to heart transplantation or as a stand-alone ‘destination therapy’ to improve quantity and quality of life for people with end-stage heart failure. Advances in cardiac imaging and non-invasive assessment of cardiac function have resulted in a diminished role for right heart catheterisation (RHC) in general cardiology practice; however, it remains an essential tool in the evaluation of potential LVAD recipients, and in their long-term management. In this review, the authors discuss practical aspects of performing RHC and potential complications. They describe the haemodynamic markers associated with a poor prognosis in patients with left ventricular systolic dysfunction and evaluate the measures of right ventricular (RV) function that predict risk of RV failure following LVAD implantation. They also discuss the value of RHC in the perioperative period; when monitoring for longer term complications; and in the assessment of potential left ventricular recovery.

Long-term mechanical circulatory support: More than 3 years on left ventricular assist device

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-2004-816621 ◽

2004 ◽

Vol 52 (S 1) ◽

Author(s):

T Drews ◽

M Jurmann ◽

R zu Dohna ◽

M Pasic ◽

Y Weng ◽

...

Keyword(s):

Mechanical Circulatory Support ◽

Left Ventricular ◽

Circulatory Support ◽

Assist Device ◽

Ventricular Assist ◽

Evaluating the Hemodynamical Response of a Cardiovascular System under Support of a Continuous Flow Left Ventricular Assist Device via Numerical Modeling and Simulations

Computational and Mathematical Methods in Medicine ◽

10.1155/2013/986430 ◽

2013 ◽

Vol 2013 ◽

pp. 1-12 ◽

Cited By ~ 10

Author(s):

Selim Bozkurt ◽

Koray K. Safak

Keyword(s):

Heart Failure ◽

Cardiovascular System ◽

Continuous Flow ◽

Left Ventricular ◽

Circulatory Support ◽

Assist Device ◽

Ventricular Assist ◽

Dilated cardiomyopathy is the most common type of the heart failure which can be characterized by impaired ventricular contractility. Mechanical circulatory support devices were introduced into practice for the heart failure patients to bridge the time between the decision to transplant and the actual transplantation which is not sufficient due to the state of donor organ supply. In this study, the hemodynamic response of a cardiovascular system that includes a dilated cardiomyopathic heart under support of a newly developed continuous flow left ventricular assist device—Heart Turcica Axial—was evaluated employing computer simulations. For the evaluation, a numerical model which describes the pressure-flow rate relations of Heart Turcica Axial, a cardiovascular system model describing the healthy and pathological hemodynamics, and a baroreflex model regulating the heart rate were used. Heart Turcica Axial was operated between 8000 rpm and 11000 rpm speeds with 1000 rpm increments for assessing the pump performance and response of the cardiovascular system. The results also give an insight about the range of the possible operating speeds of Heart Turcica Axial in a clinical application. Based on the findings, operating speed of Heart Turcica Axial should be between 10000 rpm and 11000 rpm.

The REMATCH trial: Long-term use of a left ventricular assist device for end-stage heart failure

Journal of Cardiac Failure ◽

10.1054/jcaf.2002.32944 ◽

2002 ◽

Vol 8 (2) ◽

pp. 59-60 ◽

Cited By ~ 22

Author(s):

Sharon A. Hunt ◽

Rose EA

Keyword(s):

Heart Failure ◽

Left Ventricular ◽

Assist Device ◽

Ventricular Assist ◽

Left Ventricular Assist ◽

End Stage Heart Failure ◽

End Stage

901-74 Delayed and Incomplete Reversal of Impaired Metabolic Vasodilation in Patients with Heart Failure During Long-term Circulatory Support with a Left Ventricular Assist Device

Journal of the American College of Cardiology ◽

10.1016/0735-1097(95)91551-8 ◽

1995 ◽

Vol 25 (2) ◽

pp. 22A-23A

Author(s):

Stuart D. Katz ◽

Howard Levin ◽

Milton Packer

Keyword(s):

Heart Failure ◽

Left Ventricular ◽

Circulatory Support ◽

Assist Device ◽

Ventricular Assist ◽

Left Ventricular Assist ◽

Patients With Heart Failure ◽

Metabolic Vasodilation

The Burden of Ventricular Arrhythmias Following Left Ventricular Assist Device Implantation

Arrhythmia & Electrophysiology Review ◽

10.15420/aer.2014.3.3.145 ◽

2014 ◽

Vol 3 (3) ◽

pp. 145 ◽

Cited By ~ 19

Author(s):

Jan M Griffin ◽

Jason N Katz ◽

◽

Keyword(s):

Heart Failure ◽

Ventricular Arrhythmias ◽

Left Ventricular ◽

Circulatory Support ◽

Assist Device ◽

Ventricular Assist ◽

Increased Risk ◽

Few innovations in medicine have so convincingly and expeditiously improved patient outcomes more than the development of the left ventricular assist device (LVAD). Where optimal pharmacotherapy once routinely failed those with end-stage disease, the LVAD now offers considerable hope for the growing advanced heart failure population. Despite improvements in mortality, however, mechanical circulatory support is not without its limitations. Those supported with an LVAD are at increased risk of several complications, including infection, bleeding, stroke and arrhythmic events. While once considered benign, ventricular arrhythmias in the LVAD patient are being increasingly recognised for their deleterious influence on patient morbidity and quality of life. In addition, the often multifactorial aetiology to these episodes makes treatment difficult and optimal therapeutic management controversial. Novel strategies are clearly needed to better predict, prevent, and eradicate these arrhythmias in order to allow future generations of heart failure patients to reap the full benefits of LVAD implantation.

Long-Term Circulatory Support With a Left Ventricular Assist Device Therapy in Japan

Circulation Journal ◽

10.1253/circj.cj-10-0164 ◽

2010 ◽

Vol 74 (4) ◽

pp. 624-625 ◽

Cited By ~ 10

Author(s):

Satoshi Saito ◽

Tomohiro Nishinaka ◽

Kenji Yamazaki

Keyword(s):

Left Ventricular ◽

Circulatory Support ◽

Device Therapy ◽

Assist Device ◽

Ventricular Assist ◽

Long-Term Mechanical Circulatory Support With EVAHEART Left Ventricular Assist Device

The Journal of Heart and Lung Transplantation ◽

10.1016/j.healun.2014.01.893 ◽

2014 ◽

Vol 33 (4) ◽

pp. S205

Author(s):

T. Nishinaka ◽

Y. Ichihara ◽

M. Komagamine ◽

Y. Yamada ◽

K. Yamazaki

Keyword(s):

Mechanical Circulatory Support ◽

Left Ventricular ◽

Circulatory Support ◽

Assist Device ◽

Ventricular Assist ◽

Left Ventricular Assist Device Driveline Infections

AACN Advanced Critical Care ◽

10.4037/nci.0000000000000108 ◽

2015 ◽

Vol 26 (4) ◽

pp. 300-305

Author(s):

Marc Angud

Keyword(s):

Heart Failure ◽

Heart Transplant ◽

The United States ◽

Left Ventricular ◽

Assist Device ◽

Ventricular Assist ◽

Heart failure is a chronic progressive disease that affects millions of people in the United States. Although medical management of heart failure has helped improve quality of life and survival, end-stage heart failure ultimately requires a heart transplant or long-term left ventricular assist device (LVAD) support. With more patients awaiting transplant, the demand for hearts outweighs the supply of donor hearts. The use of LVADs is increasing in patients with advanced heart failure as a treatment option for those awaiting a heart transplant or as a long-term solution if they are ineligible for a transplant. Although the LVAD is a marvel of modern medicine, infection is a cause of concern because today’s LVADs are powered externally through a percutaneous driveline that can be a major source of infection.