Hemodynamic Pump-Patient Interactions and Left Ventricular Assist Device Imaging

Narang, Nikhil; Raikhelkar, J.; Sayer, Gabriel; Uriel, Nir

doi:10.1016/j.ccl.2018.06.013

Cited by 5 publications

(3 citation statements)

References 25 publications

(27 reference statements)

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“…As such, these devices are preload-dependent and afterload-sensitive. These differences, coupled with ventricular and aortic loading conditions, contribute to the complex dynamics between the physiological response of the patient and the device itself [13].…”

Section: The Evolution Of Device Designmentioning

confidence: 99%

The Evolution and Complications of Long-Term Mechanical Circulatory Support Devices

Sargent,

Ali,

Kanamarlapudi

2024

Hearts

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Heart failure, a common clinical syndrome caused by functional and structural abnormalities of the heart, affects 64 million people worldwide. Long-term mechanical circulatory support can offer lifesaving treatment for end-stage systolic heart failure patients. However, this treatment is not without complications. This review covers the major complications associated with implantable mechanical circulatory support devices, including strokes, pump thrombosis and gastrointestinal bleeding. These complications were assessed in patients implanted with the following devices: Novacor, HeartMate XVE, CardioWest, Jarvik 2000, HeartMate II, EVAHEART, Incor, VentrAssist, HVAD and HeartMate 3. Complication rates vary among devices and remain despite the introduction of more advanced technology, highlighting the importance of device design and flow patterns. Beyond clinical implications, the cost of complications was explored, highlighting the difference in costs and the need for equitable healthcare, especially with the expected rise in the use of mechanical circulatory support. Future directions include continued improvement through advancements in design and technology to reduce blood stagnation and mitigate high levels of shear stress. Ultimately, these alterations can reduce complications and enhance cost-effectiveness, enhancing both the survival and quality of life for patients receiving mechanical circulatory support.

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Section: The Evolution Of Device Designmentioning

confidence: 99%

The Evolution and Complications of Long-Term Mechanical Circulatory Support Devices

Sargent,

Ali,

Kanamarlapudi

2024

Hearts

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“…Recent data have shown that newer-generation data have different hemodynamic pump-patient interactions; in particular, intrapericardial pumps such as the HeartWare device result in a more global than longitudinal change on echocardiogram. 4 Given these differences, how would the authors address the criteria for explantation if echocardiogram parameters such as left ventricular end-diastolic diameter and left ventricular end-systolic diameter may not be applicable?…”

Section: To the Editormentioning

confidence: 99%

Letter by Moayedi et al Regarding Article, “Prospective Multicenter Study of Myocardial Recovery Using Left Ventricular Assist Devices (RESTAGE-HF [Remission from Stage D Heart Failure]): Medium-Term and Primary End Point Results”

2021

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“…5. Stepwise increase in speed at intervals of 400 RPM for HeartMate II and 100 RPM for HVAD are then made; other protocols have shown 130-RPM intervals in the HVAD physiologically correlates with 400-RPM intervals in the HeartMate II 53)54)…”

Section: Complications Of Lvadsmentioning

confidence: 99%

Left Ventricular Assist Devices (LVADS): History, Clinical Application and Complications

Eisen

2019

Korean Circ J

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Congestive heart failure is a major cause of morbidity and mortality as well as a major health care cost in the developed world. Despite the introduction of highly effective heart failure medical therapies and simple devices such as cardiac resynchronization therapy that reduce mortality, improve cardiac function and quality of life, there remains a large number of patients who do not respond to these therapies or whose heart failure progresses despite optimal therapy. For these patients, cardiac transplantation is an option but is limited by donor availability as well as co-morbidities which may limit survival post-transplant. For these patients, left ventricular assist devices (LVADs) offer an alternative that can improve survival as well as exercise tolerance and quality of life. These devices have continued to improve as technology has improved with substantially improved durability of the devices and fewer post-implant complications. Pump thrombosis, stroke, gastrointestinal bleeding and arrhythmias post-implant have become less common with the newest devices, making destination therapy where ventricular assist device are implanted permanently in patients with advanced heart failure, a reality and an appropriate option for many patients. This may offer an opportunity for long term survival in many patients. As the first of the totally implantable devices are introduced and go to clinical trials, LVADs may be introduced that may truly be alternatives to cardiac transplantation in selected patients. Post-implant right ventricular failure remains a significant complication and better ways to identify patients at risk as well as to manage this complication must be developed.

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Hemodynamic Pump-Patient Interactions and Left Ventricular Assist Device Imaging

Cited by 5 publications

References 25 publications

The Evolution and Complications of Long-Term Mechanical Circulatory Support Devices

The Evolution and Complications of Long-Term Mechanical Circulatory Support Devices

Letter by Moayedi et al Regarding Article, “Prospective Multicenter Study of Myocardial Recovery Using Left Ventricular Assist Devices (RESTAGE-HF [Remission from Stage D Heart Failure]): Medium-Term and Primary End Point Results”

Left Ventricular Assist Devices (LVADS): History, Clinical Application and Complications

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