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Effectiveness of mechanical circulatory support devices in reversing pulmonary hypertension among heart transplant candidates: A systematic review. | LitMetric

AI Article Synopsis

  • Pulmonary hypertension is a major obstacle in determining heart transplant candidate eligibility and affects post-transplant outcomes; mechanical circulatory support (MCS) devices, like left ventricular assist devices (LVADs), can help manage this condition.
  • A systematic review of studies showed that MCS devices significantly reduce pulmonary vascular resistance and can reverse pulmonary hypertension, improving eligibility for heart transplants and potentially increasing post-transplant survival rates.
  • Further research is necessary to compare different MCS devices and establish optimal treatment protocols to enhance patient care for those facing heart transplantation challenges.

Article Abstract

Background: Pulmonary hypertension (PH) poses a significant challenge in the selection of candidates for heart transplantation, impacting their eligibility and post-transplant outcomes. Mechanical circulatory support (MCS) devices, particularly left ventricular assist devices (LVADs), have emerged as a therapeutic option to manage PH in this patient population. This systematic review aims to evaluate the effectiveness of MCS devices in reversing fixed pulmonary hypertension in heart transplant candidates.

Methods: A comprehensive literature search was conducted across multiple databases, including PubMed, Scopus, and Web of Science, to identify studies that evaluated the effectiveness of MCS devices in reversing fixed pulmonary hypertension in heart transplant candidates. Data on pulmonary vascular resistance, PH reversal, heart transplant eligibility, and post-transplant outcomes were extracted and synthesized.

Results: The review included studies that demonstrated the potential of MCS devices, especially LVADs, to significantly reduce pulmonary vascular resistance and reverse fixed pulmonary hypertension in heart transplant candidates. These findings suggest that MCS devices can improve transplant eligibility and may positively impact post-transplant survival rates. However, the literature also indicates a need for further comparative studies to optimize MCS device selection and treatment protocols.

Conclusion: MCS devices, particularly LVADs, play a crucial role in the management of fixed pulmonary hypertension in heart transplant candidates, improving their eligibility for transplantation and potentially enhancing post-transplant outcomes. Future research should focus on comparative effectiveness studies to guide clinical decision-making and optimize patient care in this challenging clinical scenario.

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Source
http://dx.doi.org/10.1016/j.cpcardiol.2024.102579DOI Listing

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