Left Ventricular Assist Devices for Lifelong Support

Continuous-flow left ventricular assist devices (LVADs) have revolutionized advanced heart failure care. These compact, fully implantable heart pumps are capable of providing meaningful increases in survival, functional capacity, and quality of life. Implantation volumes continue to grow, but severa...

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Bibliographic Details
Published in:Journal of the American College of Cardiology Vol. 69; no. 23; p. 2845
Main Authors: Pinney, Sean P, Anyanwu, Anelechi C, Lala, Anuradha, Teuteberg, Jeffrey J, Uriel, Nir, Mehra, Mandeep R
Format: Journal Article
Language:English
Published: United States 13.06.2017
Subjects:
Cost-Benefit Analysis
Heart Failure - economics
Heart Failure - psychology
Heart Failure - surgery
Heart-Assist Devices
Humans
Quality of Life
cardiothoracic surgery
heart failure
hemocompatibility
ISSN:1558-3597, 1558-3597
Online Access:Get more information
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Summary:Continuous-flow left ventricular assist devices (LVADs) have revolutionized advanced heart failure care. These compact, fully implantable heart pumps are capable of providing meaningful increases in survival, functional capacity, and quality of life. Implantation volumes continue to grow, but several challenges remain to be overcome before LVADs will be considered as the therapy of choice for all patients with advanced heart failure. They must be able to consistently extend survival for the long term (7 to 10 years), rather than the midterm (3 to 5 years) more typical of contemporary devices; they must incorporate design elements that reduce shear stress and avoid stasis to reduce the frequent adverse events of bleeding, stroke, and pump thrombosis; and they must become more cost-effective. The advancements in engineering, implantation technique, and medical management detailed in this review will highlight the progress made toward achieving lifelong LVAD support and the challenges that remain.
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ISSN:1558-3597
1558-3597
DOI:10.1016/j.jacc.2017.04.031