Complications in Patients With Ventricular Assist Devices

Abstract

Heart failure affects more than 5 million people in the United States. The treatments of this disease include medical therapy, heart transplantation, and the implantation of ventricular assist devices. These devices are used in patients who are no longer responsive to conservative medical treatment, who are not candidates for a heart transplantation (destination therapy), who are awaiting a heart transplantation (bridge to transplantation), and who have acute heart failure and whose myocardial function is expected to return to normal (bridge to recovery). Although this therapy improves the mortality and quality of life among patients with heart failure, the devices also carry risk of multiple complications. This article discusses the acute and long-term complications of ventricular assist devices.

Precision and Reliability of 5 Platelet Function Tests in Healthy Volunteers and Donors on Daily Antiplatelet Agent Therapy

“…is used as a bridge to cardiac transplant, a bridge to recovery in patients with myocardial damage, and a destination therapy for end-stage heart failure patients who are not candidates for transplant (1 ). MCS, such as left ventricular assist device (LVAD) and total artificial heart, has dramatically increased survival to transplant in both adults and children (2,3 ), although use of MCS has many complications.…”

“…MCS, such as left ventricular assist device (LVAD) and total artificial heart, has dramatically increased survival to transplant in both adults and children (2,3 ), although use of MCS has many complications. During the perioperative period, up to 60% of patients experience excess bleeding, and historically 5%-20% have experienced thromboembolism or stroke (1 ). Although some newer continuous-flow LVAD devices demonstrate lower rates of systemic thromboembolism and bleeding, device thrombosis continues to be a problem (4 ).…”

Continuous-Flow Left Ventricular Assist Device and the Right Ventricle

“…6 Right ventricular failure also increases the risk of death in LVAD patients. 7 In one study, the difference in mortality between the patients who experienced RVF and those who did not was 23.4% with RVF versus 11.9% for those without. 6 Candidate selection, RV function models, and meticulous perioperative care can improve morbidity and mortality associated with RV dysfunction after LVAD implantation.…”

Cardiac Compression Devices: Alternative Technology and Innovative Concept

“…The main cause of thromboembolism is the contact of device surface to blood and it depends on many factors including device profile, patient condition and anticoagulant regimen. It is due to cerebrovascular and peripheral embolization (23). Other less common complications are ventricular arrhythmias, stroke, neurological and psychological dysfunction, hemolysis and other organ dysfunctions (Table 2) (3,19).…”