left ventricular assist device (LVAD)

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[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]

Introduction

Mechanical left ventricular assist device.

Indications

* case of placing LVAD in 73 yo woman with BP of 161/112 mm Hg, HR of 144/min, LVEF of 20%, moderate mitral regurgitation[15]

* cardiac transplantation relatively contraindicated in patients > 72 years of agw

Contraindications

  • mortality very high in patients with ESRD[10]

Procedure

Complications

* 52% 1 year survival vs 25% with medical management

# combination drug therapy

Management

More general terms

Additional terms

References

  1. ↑ Journal Watch 21(24):197, 2001 Rose EA et al for the Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) Study Group. Long-term mechanical left ventricular assistance for end-stage heart failure. NEJM 345:1435, 2001 PMID: https://www.ncbi.nlm.nih.gov/pubmed/11794191
  2. ↑ Birks EJ et al Left ventricular assist device and drug therapy for the reversal of heart failure. N Engl J Med 2006 355:1873
    Renlund DG & Kfoury AG When the failing, end-stage heart is not end-stage. N Engl J Med 2006, 355:1922
  3. ↑ Jump up to: 3.0 3.1 Slaughter MS et al. for the HeartMate II Investigators. Advanced heart failure treated with continuous-flow left ventricular assist device. N Engl J Med. 2009 Dec 3;361(23):2241-51. Epub 2009 Nov 17. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/19920051 <Internet> http://dx.doi.org/10.1056/NEJMoa0909938
    Fang JC. Rise of the machines - Left ventricular assist devices as permanent therapy for advanced heart failure. N Engl J Med 2009 Nov 17 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/19920052 <Internet> http://dx.doi.org/10.1056/NEJMe0910394
  4. ↑ Jump up to: 4.0 4.1 Medical Knowledge Self Assessment Program (MKSAP) 15, 16, 17, 18. American College of Physicians, Philadelphia 2009, 2012, 2015, 2018.
  5. ↑ Jump up to: 5.0 5.1 Starling RC et al. Unexpected abrupt increase in left ventricular assist device thrombosis. N Engl J Med 2014 Jan 2; 370:33 PMID: https://www.ncbi.nlm.nih.gov/pubmed/24283197
  6. ↑ Jump up to: 6.0 6.1 Brock AS et al A Not-So-Obscure Cause of Gastrointestinal Bleeding N Engl J Med 2015; 372:556-561. February 5, 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25651250 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMcps1302223
  7. ↑ Garbade J, Barten MJ, Bittner HB, Mohr FW. Heart transplantation and left ventricular assist device therapy: two comparable options in end-stage heart failure? Clin Cardiol. 2013 Jul;36(7):378-82 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23595910
  8. ↑ Jump up to: 8.0 8.1 Mehra MR et al. A fully magnetically levitated circulatory pump for advanced heart failure. N Engl J Med 2016 Nov 16 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27959709 <Internet> http://www.nejm.org/doi/10.1056/NEJMoa1610426
  9. ↑ Jump up to: 9.0 9.1 Rogers JG et al. Intrapericardial left ventricular assist device for advanced heart failure. N Engl J Med 2017 Feb 2; 376:451. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28146651 Free Article <Internet> http://www.nejm.org/doi/10.1056/NEJMoa1602954
    Hetzer R, Delmo Walter EM. Mechanical circulatory support devices - in progress. N Engl J Med 2017 Feb 2; 376:487 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28146667 <Internet> http://www.nejm.org/doi/10.1056/NEJMe1613755
  10. ↑ Jump up to: 10.0 10.1 Bansal N, Hailpern SM, Katz R et al. Outcomes associated with left ventricular assist devices among recipients with and without end-stage renal disease. JAMA Intern Med 2017 Dec 18; PMID: https://www.ncbi.nlm.nih.gov/pubmed/29255896
    Thomas SS et al. The Renal Challenge With Left Ventricular Assist Device Therapy-When Enough Is Enough. JAMA Intern Med. 2017 Dec 18. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29255894
  11. ↑ Jump up to: 11.0 11.1 Mehra MR, Goldstein DJ, Uriel N et al. Two-year outcomes with a magnetically levitated cardiac pump in heart failure. N Engl J Med 2018; 378:1386-1395. April 12, 2018. ePub Mar 11 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29526139 <Internet> http://www.nejm.org/doi/10.1056/NEJMoa1800866
  12. ↑ Robertson J, Long B, Koyfman A. The emergency management of ventricular assist devices. Am J Emerg Med. 2016 Jul;34(7):1294-301. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/27162114
  13. ↑ Stokes MB, Bergin P, McGiffin D. Role of long-term mechanical circulatory support in patients with advanced heart failure. Intern Med J. 2016 May;46(5):530-40. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/26010730
  14. ↑ Stokes MB, Saxena P, Mariani JA et al Left Ventricular Assist Device (LVAD) as a Bridge to Recovery for Tachycardia-Mediated Cardiomyopathy. J Card Surg. 2015 Nov;30(11):871-3. dEpub 2015 Sep 8. PMID: https://www.ncbi.nlm.nih.gov/pubmed/26350745
  15. ↑ Jump up to: 15.0 15.1 Geriatric Review Syllabus, 10th edition (GRS10) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2019
    Geriatric Review Syllabus, 12th edition (GRS12) Colburn JL, Wescott AM, Potter JF (eds) American Geriatrics Society, 2025
  16. ↑ Hamad EA, Byku M, Larson SB, Billia F. LVAD therapy as a catalyst to heart failure remission and myocardial recovery. Clin Cardiol. 2023 Oct;46(10):1154-1162. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37526373 PMCID: PMC10577530 Free PMC article. Review. https://pmc.ncbi.nlm.nih.gov/articles/PMC10577530/
  17. ↑ Kanwar MK, McIlvennan CK, Lohmueller LC et al Defining Optimal Outcomes in Patients with Left Ventricular Assist Devices. ASAIO J. 2021 Apr 1;67(4):397-404. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32701625
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