Engineering advancements have expanded the role for mechanical circulatory support devices in the patient with heart failure. More patients with mechanical circulatory support are being discharged from the implanting institution and will be seen by clinicians outside the immediate surgical or heart-failure team. This review provides a practical understanding of device design and physiology, general troubleshooting, and limitations and complications for implantable left ventricular assist devices (pulsatile-flow and continuous-flow pumps) and the total artificial heart.
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http://dx.doi.org/10.1002/clc.20825 | DOI Listing |
Br J Hosp Med (Lond)
December 2024
Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Cardiogenic shock (CS) is associated with significant mortality. Advances in pharmacological therapies and mechanical circulatory support (MCS) devices have markedly improved the therapeutic approach to CS, though treatment efficacy and safety vary. The recent DanGer shock trial showed a significant reduction in 6-month mortality for CS patients due to acute myocardial infarction.
View Article and Find Full Text PDFAnn Pediatr Cardiol
December 2024
Department of Cardiac Sciences, Institute of Heart and Lung Transplantation and Mechanical Circulatory Support, MGM Healthcare, Chennai, Tamil Nadu, India.
End-stage heart failure due to left ventricular noncompaction (LVNC) poses unique challenges for ventricular assist device implantation, like inflow cannula obstruction due to trabeculations. We report a case of an 11-year-old boy with LVNC who underwent successful HeartWare implantation as a bridge to transplant for high pulmonary vascular resistance and had successful heart transplantation after 4 years of HeartWare support.
View Article and Find Full Text PDFFront Cardiovasc Med
January 2025
Department of Intensive Care Medicine, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, China.
A young female patient suffered cardiogenic shock after undergoing surgery for an ectopic pregnancy. Coronary artery computed tomography angiography (CTA) revealed a left main artery (LM) originating from the right coronary sinus and traveling between the aorta and pulmonary artery. We successfully resuscitated the patient with mechanical circulatory support using veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and an intra-aortic balloon pump (IABP).
View Article and Find Full Text PDFCirc Heart Fail
January 2025
The CardioVascular Center, Tufts Medical Center, Boston, MA (S.L.H., K.D.E., G.G., N.K.K.).
The integrative physiology of the left ventricle and systemic circulation is fundamental to our understanding of advanced heart failure and cardiogenic shock. In simplest terms, any increase in aortic stiffness increases the vascular afterload presented to the failing left ventricle. The net effect is increased myocardial oxygen demand and reduced coronary perfusion pressure, thereby further deteriorating contractile function.
View Article and Find Full Text PDFESC Heart Fail
January 2025
Division of Cardiology, Department of Medicine, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Aims: Right ventricular (RV) failure (RVF) after left ventricular assist device (LVAD) implant is an important cause of morbidity and mortality. Modern, data-driven approaches for defining and predicting RVF have been under-utilized.
Methods: Two hundred thirty-two patients were identified with a mean age of 55 years; 40 (17%) were women, 132 were (59%) Caucasian and 74 (32%) were Black.
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