scholarly journals Fifteen years of the first Brazilian Centrifugal Ventricular Assist Device for long term Mechanically Assisted Circulatory Support

2021 ◽  
pp. 1-12
Author(s):  
Eduardo Bock
Keyword(s):  
Heart Failure ◽  
Science Fiction ◽  
Emerging Economies ◽  
Ventricular Assist Device ◽  
Review Paper ◽  
Circulatory Support ◽  
Fake News ◽  
Assist Device ◽  
Ventricular Assist

More than simply being a review paper and telling the story of the development of a ventricular assist device, this paper aims to critically review changes in technical nomenclature and scientific positioning, taxonomy and its applications, therapeutic indications and the results of its application in patients. After 15 years of the first Brazilian Centrifugal Ventricular Assist Device, many things have changed for the better. Mechanically Assisted Circulatory Support is a therapy consolidated as a safe and effective alternative for the treatment of congestive heart failure, as well as heart transplantation and other drug therapies. It is still seen as science fiction in several countries or media, but that is a cruel reality in our post-truth and fake news times. In reality, it should receive more funding resources especially in developing countries and emerging economies with strong hospital industry of the cardiovascular field that may have surprising results with all the technology already established.

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

2021 ◽  
Vol 16 ◽  
Author(s):  
Jesus Gonzalez ◽  
Paul Callan
Keyword(s):  
Heart Failure ◽  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Left Ventricular ◽  
Circulatory Support ◽  
Assist Device ◽  
Ventricular Assist ◽  
Right Heart Catheterisation ◽  
Left Ventricular Assist

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.

scholarly journals Pediatric Palliative Care in the Heart Failure, Ventricular Assist Device and Transplant Populations: Supporting Patients, Families and Their Clinical Teams

Children ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. 468
Author(s):  
Kyle D. Hope ◽  
Priya N. Bhat ◽  
William J. Dreyer ◽  
Barbara A. Elias ◽  
Jaime L. Jump ◽  
...  
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Heart Transplantation ◽  
Ventricular Assist Device ◽  
Mechanical Circulatory Support ◽  
Pediatric Palliative Care ◽  
Circulatory Support ◽  
Assist Device ◽  
Ventricular Assist ◽  
Patients With Heart Failure

Heart failure is a life-changing diagnosis for a child and their family. Pediatric patients with heart failure experience significant morbidity and frequent hospitalizations, and many require advanced therapies such as mechanical circulatory support and/or heart transplantation. Pediatric palliative care is an integral resource for the care of patients with heart failure along its continuum. This includes support during the grief of a new diagnosis in a child critically ill with decompensated heart failure, discussion of goals of care and the complexities of mechanical circulatory support, the pensive wait for heart transplantation, and symptom management and psychosocial support throughout the journey. In this article, we discuss the scope of pediatric palliative care in the realm of pediatric heart failure, ventricular assist device (VAD) support, and heart transplantation. We review the limited, albeit growing, literature in this field, with an added focus on difficult conversation and decision support surrounding re-transplantation, HF in young adults with congenital heart disease, the possibility of destination therapy VAD, and the grimmest decision of VAD de-activation.

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

2013 ◽  
Vol 2013 ◽  
pp. 1-12 ◽  
Author(s):  
Selim Bozkurt ◽  
Koray K. Safak
Keyword(s):  
Heart Failure ◽  
Cardiovascular System ◽  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Continuous Flow ◽  
Left Ventricular ◽  
Circulatory Support ◽  
Assist Device ◽  
Ventricular Assist ◽  
Left 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.

scholarly journals The Burden of Ventricular Arrhythmias Following Left Ventricular Assist Device Implantation

2014 ◽  
Vol 3 (3) ◽  
pp. 145 ◽  
Author(s):  
Jan M Griffin ◽  
Jason N Katz ◽  
◽  
Keyword(s):  
Heart Failure ◽  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Ventricular Arrhythmias ◽  
Left Ventricular ◽  
Circulatory Support ◽  
Assist Device ◽  
Ventricular Assist ◽  
Increased Risk ◽  
Left Ventricular Assist

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.

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