Cardiac Support Devices

2017 ◽  
Author(s):  
Charles C. Hill ◽  
Lindsay Raleigh
Keyword(s):  
Heart Failure ◽  
Cardiogenic Shock ◽  
Mechanical Circulatory Support ◽  
Life Support ◽  
Ventricular Assist Devices ◽  
Circulatory Support ◽  
Short Term ◽  
Assist Device ◽  
Ventricular Assist

Mechanical circulatory support (MCS) involves the use of intra-aortic balloon pump (IABP), short-term percutaneous ventricular assist devices, long-term surgically implanted continuous-flow ventricular assist devices (cf-LVADs), and extracorporeal membrane oxygenation (ECMO) for the treatment of acute and chronic heart failure and cardiogenic shock. IABP is increasingly recognized as an important adjunct in the postoperative treatment arsenal for those patients with severely reduced left ventricular systolic function. Short-term percutaneous options for the treatment of acute right and left heart failure include both the Impella and Tandem Heart, whereas the Centrimag is often used in the surgical setting for acute cardiogenic shock and heart failure. Long-term surgical MCS options include the total artificial heart and the cf-LVADs HeartWare and Heartmate II. ECMO is frequently used for the treatment of acute cardiogenic shock and may be placed peripherally via a percutaneous approach or with central cannulation. ECMO is also increasingly used in the setting of acute cardiac life support, known as extracorporeal life support. Key words: cardiac critical care, extracorporeal membrane oxygenation, long-term ventricular assist device, mechanical circulatory support, short-term ventricular assist device 

Cardiac Support Devices

2017 ◽  
Author(s):  
Charles C. Hill ◽  
Lindsay Raleigh
Keyword(s):  
Heart Failure ◽  
Cardiogenic Shock ◽  
Mechanical Circulatory Support ◽  
Life Support ◽  
Ventricular Assist Devices ◽  
Circulatory Support ◽  
Short Term ◽  
Assist Device ◽  
Ventricular Assist

Mechanical circulatory support (MCS) involves the use of intra-aortic balloon pump (IABP), short-term percutaneous ventricular assist devices, long-term surgically implanted continuous-flow ventricular assist devices (cf-LVADs), and extracorporeal membrane oxygenation (ECMO) for the treatment of acute and chronic heart failure and cardiogenic shock. IABP is increasingly recognized as an important adjunct in the postoperative treatment arsenal for those patients with severely reduced left ventricular systolic function. Short-term percutaneous options for the treatment of acute right and left heart failure include both the Impella and Tandem Heart, whereas the Centrimag is often used in the surgical setting for acute cardiogenic shock and heart failure. Long-term surgical MCS options include the total artificial heart and the cf-LVADs HeartWare and Heartmate II. ECMO is frequently used for the treatment of acute cardiogenic shock and may be placed peripherally via a percutaneous approach or with central cannulation. ECMO is also increasingly used in the setting of acute cardiac life support, known as extracorporeal life support. Key words: cardiac critical care, extracorporeal membrane oxygenation, long-term ventricular assist device, mechanical circulatory support, short-term ventricular assist device 

Cardiac Support Devices

2018 ◽  
Author(s):  
Charles C. Hill ◽  
Lindsay Raleigh
Keyword(s):  
Heart Failure ◽  
Cardiogenic Shock ◽  
Mechanical Circulatory Support ◽  
Life Support ◽  
Ventricular Assist Devices ◽  
Circulatory Support ◽  
Short Term ◽  
Assist Device ◽  
Ventricular Assist

Mechanical circulatory support (MCS) involves the use of intra-aortic balloon pump (IABP), short-term percutaneous ventricular assist devices, long-term surgically implanted continuous-flow ventricular assist devices (cf-LVADs), and extracorporeal membrane oxygenation (ECMO) for the treatment of acute and chronic heart failure and cardiogenic shock. IABP is increasingly recognized as an important adjunct in the postoperative treatment arsenal for those patients with severely reduced left ventricular systolic function. Short-term percutaneous options for the treatment of acute right and left heart failure include both the Impella and Tandem Heart, whereas the Centrimag is often used in the surgical setting for acute cardiogenic shock and heart failure. Long-term surgical MCS options include the total artificial heart and the cf-LVADs HeartWare and Heartmate II. ECMO is frequently used for the treatment of acute cardiogenic shock and may be placed peripherally via a percutaneous approach or with central cannulation. ECMO is also increasingly used in the setting of acute cardiac life support, known as extracorporeal life support. Key words: cardiac critical care, extracorporeal membrane oxygenation, long-term ventricular assist device, mechanical circulatory support, short-term ventricular assist device 

scholarly journals Mechanical Circulatory Support in Advanced Heart Failure

2021 ◽  
pp. 263246362110327
Author(s):  
Sonali Arora ◽  
Auras R. Atreya
Keyword(s):  
Heart Failure ◽  
Cardiogenic Shock ◽  
Heart Transplantation ◽  
Medical Therapy ◽  
Mechanical Circulatory Support ◽  
Advanced Heart Failure ◽  
Ventricular Assist Devices ◽  
Circulatory Support ◽  
Ventricular Assist ◽  
Advanced Therapies

Advanced heart failure (HF) with persistent and progressive clinical decline despite maximal medical therapy portends a high mortality in the absence of advanced therapies, such as ventricular assist devices or heart transplantation. A subset of these advanced HF patients deteriorates into refractory cardiogenic shock, that is challenging to manage with vasoactive agents alone. Temporary mechanical circulatory support (MCS) device options have evolved over the years and provide a viable option to rescue and rest the myocardium of patients in cardiogenic shock. The goal of such therapy is to serve as bridge to recovery, or more often, a bridge to durable advanced therapies. For those patients with progressive advanced HF despite extensive medical therapy, durable MCS devices (ventricular assist devices) are available when heart transplantation is not feasible. In this article, we review currently available temporary and durable MCS devices, with a focus on their hemodynamic profiles, to inform optimal device selection for patients with advanced HF.

scholarly journals Prediction of survival of patients in cardiogenic shock treated by surgically implanted Impella 5+ short-term left ventricular assist device

2020 ◽  
Vol 31 (4) ◽  
pp. 475-482
Author(s):  
Gaik Nersesian ◽  
Carsten Tschöpe ◽  
Frank Spillmann ◽  
Tom Gromann ◽  
Luise Roehrich ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Cardiogenic Shock ◽  
Mechanical Circulatory Support ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Circulatory Support ◽  
Left Ventricular Assist Devices ◽  
Short Term ◽  
Ventricular Assist ◽  
Left Ventricular Assist

Abstract OBJECTIVES Short-term mechanical circulatory support is a life-saving treatment for acute cardiogenic shock (CS). This multicentre study investigates the preoperative predictors of 30-day mortality in CS patients treated with Impella 5.0 and 5.5 short-term left ventricular assist devices. METHODS Data of patients in CS (n = 70) treated with the Impella 5 (n = 63) and 5.5 (n = 7) in 2 centres in Berlin between October 2016 and October 2019 were collected retrospectively. RESULTS CS was caused by acute myocardial infarction (n = 16), decompensated chronic heart failure (n = 41), postcardiotomy syndrome (n = 5) and acute myocarditis (n = 8). Before implantation 12 (17%) patients underwent cardiopulmonary resuscitation and 32 (46%) patients were ventilated. INTERMACS level 1, 2 and 3 was established in 35 (50%), 29 (41%) and 6 (9%) of patients, respectively. The mean preoperative lactate level was 4.05 mmol/l. The median support time was 7 days (IR= 4–15). In 18 cases, the pump was removed for myocardial recovery, in 22 cases, durable left ventricular assist devices were implanted, and 30 patients died on support. The overall 30-day survival was 51%. Statistical analysis showed that an increase in lactate per mmol/l [odds ratio (OR) 1.217; P = 0.015] and cardiopulmonary resuscitation before implantation (OR 16.74; P = 0.009) are predictors of 30-day survival. Based on these data, an algorithm for optimal short-term mechanical circulatory support selection is proposed. CONCLUSIONS Impella treatment is feasible in severe CS. Severe organ dysfunction, as well as the level and duration of shock predict early mortality. An algorithm based on these parameters may help identify patients who would benefit from Impella 5+ support.

Bridging to a Long-Term Ventricular Assist Device With Short-Term Mechanical Circulatory Support

2018 ◽  
Vol 42 (6) ◽  
pp. 589-596 ◽  
Author(s):  
Chitaru Kurihara ◽  
Masashi Kawabori ◽  
Tadahisa Sugiura ◽  
Andre C. Critsinelis ◽  
Suwei Wang ◽  
...  
Keyword(s):  
Ventricular Assist Device ◽  
Mechanical Circulatory Support ◽  
Circulatory Support ◽  
Short Term ◽  
Assist Device ◽  
Ventricular Assist

scholarly journals A Review of Long-Term Mechanical Circulatory Support as Destination Therapy: Evolving Paradigms for Treatment of Advanced Heart Failure

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Ali A. Valika ◽  
William Cotts
Keyword(s):  
Heart Failure ◽  
Mechanical Circulatory Support ◽  
Advanced Heart Failure ◽  
Ventricular Assist Devices ◽  
Circulatory Support ◽  
Destination Therapy ◽  
Device Therapy ◽  
Ventricular Assist ◽  
Assist Devices

Left ventricular assist devices as long-term mechanical circulatory support are increasingly utilized as an option for medically refractory advanced heart failure. Rapid advances in this field, from pulsatile paracorporeal flow pumps to now more advanced intracorporeal continuous flow devices, have led to more wide spread use of device therapy. Several trials have now confirmed the survival benefits of ventricular assist devices, not only as a method for bridging patients waiting on the transplant list, but also as an evolving paradigm of destination therapy. Significant improvements in quality of life and functional status have been reported in patients receiving these devices. Survival outcomes with this therapy continue to improve, and long term durability of newer generation devices remains yet to be discerned. Comparative data to heart transplantation remains scarce. This paper will focus on the historical development of ventricular assist device therapy for advanced heart failure, review major trials of destination therapy, and look at comparative literature in the modern era to cardiac transplantation.

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