Faculty Collaboration Database

Current Status of Left Ventricular Assist Device Therapy. Mayo Clin Proc 2016 Jul;91(7):927-40

Date

07/06/2016

Pubmed ID

27378038

DOI

10.1016/j.mayocp.2016.05.002

Scopus ID

2-s2.0-84991706726 (requires institutional sign-in at Scopus site)   47 Citations

Abstract

Congestive heart failure (HF) remains a serious burden in the Western World. Despite advances in pharmacotherapy and resynchronization, many patients have progression to end-stage HF. These patients may be candidates for heart transplant or left ventricular assist device (LVAD) therapy. Heart transplants are limited by organ shortages and in some cases by patient comorbidities; therefore, LVAD therapy is emerging as a strategy of bridge to transplant or as a destination therapy in patients ineligible for transplant. Patients initially ineligible for a transplant may, in certain cases, become eligible for transplant after physiologic improvement with LVAD therapy, and a small number of patients with an LVAD may have sufficient recovery of myocardial function to allow device explantation. This clinically oriented review will describe (1) the most frequently used pump types and aspects of the continuous-flow physiology and (2) the clinical indications for and the shift toward the use of LVADs in less sick patients with HF. Additionally, we review complications of LVAD therapy and project future directions in this field. We referred to the Interagency Registry for Mechanically Assisted Circulatory Support, landmark trials, and results from recently published studies as major sources in obtaining recent outcomes, and we searched for related published literature via PubMed. This review focuses primarily on clinical practice for primary care physicians and non-HF cardiologists in the United States.

Author List

Sajgalik P, Grupper A, Edwards BS, Kushwaha SS, Stulak JM, Joyce DL, Joyce LD, Daly RC, Kara T, Schirger JA

MESH terms used to index this publication - Major topics in bold

Comorbidity
Heart Failure
Heart Transplantation
Heart-Assist Devices
Humans
Thrombosis
Tissue and Organ Procurement