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Current State of Ventricular Assist Devices

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Abstract

Left ventricular assist device (LVAD) support is an accepted treatment of patients with end-stage heart failure. The increased applicability and excellent results with LVADs have revolutionized the treatment options available for such patients. Success with LVADs as bridge-to-transplant therapy has led to their successful use as an alternate to a transplant (ie, as destination therapy [DT]). The use of these devices as DT represents a relatively newer but growing indication. Until recently, most patients who have undergone LVAD implantation have been supported by pulsatile devices. Newer continuous-flow (CF) pumps have resulted in superior outcomes, including significantly reduced complication rates with improved durability over first-generation pulsatile design pumps. However, as with all new technology, the newer LVADs have introduced management challenges that were either unimportant or absent with pulsatile LVADs. This article reviews the current state of left ventricular devices, focusing on the CF pumps that currently dominate the field, including clinical outcomes, the physiologic and pathologic effects that are associated with CF pumps, and their unique management issues and complications.

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Papers of particular interest, published recently, have been highlighted as: •Of importance, ••Of major importance

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Disclosures

Dr. M. Caccamo: none. Dr. Peter Eckman has received grants, honoraria, travel expense compensation, and payment for the development of educational presentations from Thoratec Corporation. Research grants from HeartWare and Thoratec Corporation have been paid to the University of Minnesota on behalf of Dr. Ranjit John.

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Authors and Affiliations

  1. Department of Medicine, Division of Cardiovascular Medicine, University of Minnesota, Minneapolis, MN, USA

    Marco Caccamo & Peter Eckman

  2. Department of Cardiothoracic Surgery, Division of Surgery, University of Minnesota, 420 Delaware Street Southeast, Minneapolis, MN, 55455, USA

    Ranjit John

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  1. Marco Caccamo
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Correspondence to Ranjit John.

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Caccamo, M., Eckman, P. & John, R. Current State of Ventricular Assist Devices. Curr Heart Fail Rep 8, 91–98 (2011). https://doi.org/10.1007/s11897-011-0050-z

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