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Operative Techniques and Recent Advances in Acute Care and Emergency Surgery pp 749–757Cite as

Mechanical Circulatory Support: LVAD in Heart Failure

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Abstract

Advanced heart failure is a serious medical condition with a poor prognosis despite optimal medical management. Heart transplantation remains the gold standard for the treatment of advanced heart failure, but it is severely limited by chronic donor shortage. In such scenario, contemporary continuous flow LVAD is emerging as an alternative to transplant in very selected patients. A thorough evaluation of the right ventricular function is mandatory before implantation because the device will support only the left ventricle. Survival is 80 and 70% at 1 and 2 years after LVAD implantation, respectively. During support, patients experience a significant improvement in functional status and quality of life, even if it is still inferior when compared to heart transplantation. LVAD also allows the treatment of severe reversible pulmonary hypertension, decreasing the risk of the transplantation. Most frequent complications observed during support are bleeding and infection. LVAD thrombosis, albeit much less frequent, is a life-threatening event that can lead to pump stop and even death. Treatment options for thrombosis are thrombolytic therapy, LVAD replacement, and urgent transplantation.

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Author information

Authors and Affiliations

  1. Department of Cardiac Surgery, Niguarda Hospital, Milan, Italy

    Aldo Cannata & Claudio Francesco Russo

  2. Department of Cardiac and Thoraco-Vascular Surgery, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

    Aldo Cannata & Claudio Francesco Russo

Authors
  1. Aldo Cannata
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  2. Claudio Francesco Russo
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Correspondence to Aldo Cannata .

Editor information

Editors and Affiliations

  1. Dipartimento di Emergenza Urgenza, ASST Grande Ospedale Metropolitano Niguarda, Milan, Milano, Italy

    Paolo Aseni

  2. School of Medicine, University of Milano-Bicocca, Niguarda Hospital, Milan, Milano, Italy

    Luciano De Carlis

  3. Department of Cardiac Surgery, IRCCS MultiMedica, Milan, Milano, Italy

    Alessandro Mazzola

  4. Department of Cardiac Surgery, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy

    Antonino M. Grande

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Cannata, A., Russo, C.F. (2019). Mechanical Circulatory Support: LVAD in Heart Failure. In: Aseni, P., De Carlis, L., Mazzola, A., Grande, A.M. (eds) Operative Techniques and Recent Advances in Acute Care and Emergency Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-95114-0_52

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  • DOI: https://doi.org/10.1007/978-3-319-95114-0_52

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-95113-3

  • Online ISBN: 978-3-319-95114-0

  • eBook Packages: MedicineMedicine (R0)

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