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.

scholarly journals Destination Therapy with Left Ventricular Assist Devices in Non-transplant Centres: The Time is Right

2020 ◽  
Vol 15 ◽  
Author(s):  
Antoni Bayes-Genis ◽  
Christian Muñoz-Guijosa ◽  
Evelyn Santiago-Vacas ◽  
Santiago Montero ◽  
Cosme García-García ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Cardiac Transplant ◽  
Destination Therapy ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Assist Devices ◽  
Long Term Treatment ◽  
Left Ventricular Assist

For almost half a century, cardiac transplant has been the only long-term treatment for patients with end-stage heart failure. Implantable left ventricular assist devices (LVADs) have emerged as a new treatment option for advanced heart failure as destination therapy for patients either too old or not suitable for transplant. A meta-analysis presenting head-to-head comparisons of cardiac transplant versus LVAD as destination therapy (LVAD-DT) found no difference in 1-year mortality rates between LVAD-DT and cardiac transplant (OR 1.49; 95% CI [0.48–4.66]; I2=82.8%). Moreover, a recent subanalysis from the Interagency Registry for Mechanically Assisted Circulatory Support found similar outcomes after LVAD-DT implantation in both transplant and non-transplant centres. The time is right for LVAD-DT in non-transplant centres, provided multidisciplinary heart failure teams and expertise are in place.

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.

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