The Fountain of Youth Will Not Last Forever: End of Life in Patients Receiving Mechanical Circulatory Support

2021 ◽  
Vol 32 (4) ◽  
pp. 452-460
Author(s):  
Mary H. Johnson ◽  
Colleen Bass ◽  
Sarah E. Schroeder
Keyword(s):  
End Of Life ◽  
Health Care Providers ◽  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Left Ventricular ◽  
Circulatory Support ◽  
Care Providers ◽  
Assist Device ◽  
Ventricular Assist ◽  
Left Ventricular Assist

Health care providers face a unique set of decision-making, assessment, and equipment challenges at the end of life of patients supported with a left ventricular assist device. The aim for this article is to assist the multidisciplinary team in caring for patients with a left ventricular assist device in all phases of end-of-life care. This review includes common causes of death for patients with a left ventricular assist device, assessment at end of life, physiological and palliative care considerations, withdrawal of left ventricular assist device support, and equipment considerations.

Outcome of Temporary Circulatory Support As a Bridge-to-Left Ventricular Assist Device Strategy in Cardiogenic Shock Patients

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Auriane Bidaut ◽  
Erwan Flécher ◽  
Nicolas Nesseler ◽  
Karl Bounader ◽  
André Vincentelli ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Left Ventricular ◽  
Circulatory Support ◽  
Assist Device ◽  
Ventricular Assist ◽  
Left Ventricular Assist

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 An unusual presentation of bradycardia, acidosis, and right ventricular dysfunction after left ventricular assist device implantation: A case report

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Jennifer M Elia ◽  
◽  
Karen H Katrivesis ◽  
Ali A Naqvi ◽  
Fabio M Sagebin ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Prediction Models ◽  
Early Recognition ◽  
Left Ventricular ◽  
Circulatory Support ◽  
Assist Device ◽  
Ventricular Assist ◽  
Left Ventricular Assist

Right Ventricular (RV) dysfunction is a common complication seen in 20-50% of patients after Left-Ventricular Assist Device (LVAD) implantation. Although prediction models exist, it is challenging to prevent RV dysfunction and even more difficult to manage. Early recognition is crucial to determine the appropriate pharmacological therapies and decide if implementation of Mechanical Circulatory Support (MCS) is needed. Here, we present a case of RV dysfunction precipitated unexpectedly by a bradycardic episode. The RV dysfunction was refractory to traditional therapies but was successfully managed with right-sided MCS.

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