Skip to main content
SpringerLink
Log in

Ventricular Assist Devices

  • Chapter
  • First Online:
Klinische Kardiologie

Part of the book series: Springer Reference Medizin ((SRM))

  • 1353 Accesses

Zusammenfassung

Die mechanische Herz-Kreislauf-Unterstützung, insbesondere durch linksventrikuläre Assist Devices (LVAD), hat sich zu einer etablierten Therapie der chronischen Herzinsuffizienz entwickelt. Die Hauptindikationen sind die Überbrückung zur Transplantation sowie mit zunehmendem Stellenwert die Destinationstherapie. Die Indikationsstellung erfolgt anhand der klinischen Symptomatik entsprechend der InterMACS-Klassifikation. Bei kritisch kranken Patienten besteht die Möglichkeit der temporären Herzunterstützung durch Anlage eines Kurzzeitunterstützungssystems zur Stabilisierung und Entscheidungsfindung vor einer permanenten Unterstützung. Für die aktuelle LVAD-Generation, bei der die miniaturisierte, magnetisch gelagerte Pumpe intraperikardial im Apex des linken Ventrikels platziert wird, kann ein 1-Jahres-Überleben von 80–85 %, analog zur Herztransplantation, erreicht werden. Potenzielle Komplikationen beinhalten ein Thrombembolierisiko, Blutungen sowie Device-assoziierte Infektionen.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 239.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

Literatur

  • Aaronson KD, Slaughter MS, Miller LW, McGee EC, Cotts WG, Acker MA, Jessup ML, Gregoric ID, Loyalka P, Frazier OH, Jeevanandam V, Anderson AS, Kormos RL, Teuteberg JJ, Levy WC, Naftel DC, Bittman RM, Pagani FD, Hathaway DR, Boyce SW (2012) Use of an intrapericardial, continuous-flow, centrifugal pump in patients awaiting heart transplantation. Circulation 125(25):3191–3200. https://doi.org/10.1161/circulationaha.111.058412

    Article  PubMed  Google Scholar 

  • Asuka E, Pak S, Thiess A-K, Torres A 3rd (2020) Gastrointestinal bleeding as a complication in continuous flow ventricular assist devices: a systematic review with meta-analysis. J Clin Med Res 12(9):543–559. https://doi.org/10.14740/jocmr4262

    Article  PubMed  PubMed Central  Google Scholar 

  • Birati EY, Hanff TC, Maldonado D, Grandin EW, Kennel PJ, Mazurek JA, Vorovich E, Seigerman M, Howard JLL, Acker MA, Naka Y, Wald J, Goldberg LR, Jessup M, Atluri P, Margulies KB, Schulze PC, Rame JE (2018) Predicting long term outcome in patients treated with continuous flow left ventricular assist device: the Penn-Columbia Risk Score. J Am Heart Assoc 7(6). https://doi.org/10.1161/JAHA.117.006408

  • Bourque K, Cotter C, Dague C, Harjes D, Dur O, Duhamel J, Spink K, Walsh K, Burke E (2016) Design rationale and preclinical evaluation of the HeartMate 3 left ventricular assist system for hemocompatibility. ASAIO J 62(4):375–383. https://doi.org/10.1097/mat.0000000000000388

    Article  PubMed  Google Scholar 

  • Briasoulis A, Ueyama H, Kuno T, Asleh R, Briasouli A, Doulamis I, Malik AH (2021) Analysis of trends and outcomes of 90 and 180 day readmissions after left ventricular assist device implantation. ASAIO J. https://doi.org/10.1097/mat.0000000000001486

  • Cascino TM, Aaronson KD, Stewart GC (2019) Identifying stage D heart failure: data from the most recent registries. Curr Heart Fail Rep 16(5):130–139. https://doi.org/10.1007/s11897-019-00433-2

    Article  PubMed  Google Scholar 

  • DeBakey ME (1971) Left ventricular bypass pump for cardiac assistance. Clinical experience. Am J Cardiol 27(1):3–11. https://doi.org/10.1016/0002-9149(71)90076-2

    Article  PubMed  Google Scholar 

  • E YB, Jessup M (2015) Left ventricular assist devices in the management of heart failure. Card Fail Rev 1(1):25–30. https://doi.org/10.15420/cfr.2015.01.01.25

    Article  Google Scholar 

  • Frazier OH (1994) First use of an untethered, vented electric left ventricular assist device for long-term support. Circulation 89(6):2908–2914. https://doi.org/10.1161/01.cir.89.6.2908

    Article  PubMed  Google Scholar 

  • Frazier OH, Macris MP, Myers TJ, Duncan JM, Radovancevic B, Parnis SM, Cooley DA (1994) Improved survival after extended bridge to cardiac transplantation. Ann Thorac Surg 57(6):1416–1422; discussion 1421–1412. https://doi.org/10.1016/0003-4975(94)90094-9

    Article  PubMed  Google Scholar 

  • Gibbon JH Jr (1954) Application of a mechanical heart and lung apparatus to cardiac surgery. Minn Med 37(3):171–185; passim

    PubMed  Google Scholar 

  • Grant ADM, Smedira NG, Starling RC, Marwick TH (2012) Independent and incremental role of quantitative right ventricular evaluation for the prediction of right ventricular failure after left ventricular assist device implantation. J Am Coll Cardiol 60(6):521–528. https://doi.org/10.1016/j.jacc.2012.02.073

    Article  PubMed  Google Scholar 

  • Gregoric ID (2013) Triage VADs: TandemHeart, Impella, and CentriMag. In: Morgan JA, Naka Y (Hrsg) Surgical treatment for advanced heart failure. Springer, New York, S 93–107. https://doi.org/10.1007/978-1-4614-6919-3_8

    Chapter  Google Scholar 

  • Gustafsson F, Ben Avraham B, Chioncel O, Hasin T, Grupper A, Shaul A, Nalbantgil S, Hammer Y, Mullens W, Tops LF, Elliston J, Tsui S, Milicic D, Altenberger J, Abuhazira M, Winnik S, Lavee J, Piepoli MF, Hill L, Hamdan R, Ruhparwar A, Anker S, Crespo-Leiro MG, Coats AJS, Filippatos G, Metra M, Rosano G, Seferovic P, Ruschitzka F, Adamopoulos S, Barac Y, De Jonge N, Frigerio M, Goncalvesova E, Gotsman I, Itzhaki Ben Zadok O, Ponikowski P, Potena L, Ristic A, Jaarsma T, Ben Gal T (2021) HFA of the ESC position paper on the management of LVAD-supported patients for the non-LVAD specialist healthcare provider Part 3: at the hospital and discharge. ESC Heart Fail. https://doi.org/10.1002/ehf2.13590

  • Hanff TC, Birati EY (2019) Left ventricular assist device as destination therapy: a state of the science and art of long-term mechanical circulatory support. Curr Heart Fail Rep 16(5):168–179. https://doi.org/10.1007/s11897-019-00438-x

    Article  PubMed  Google Scholar 

  • Hannan MM, Xie R, Cowger J, Schueler S, de By T, Dipchand AI, Chu VH, Cantor RS, Koval CE, Krabatsch T, Hayward CS, Nakatani T, Kirklin JK (2019) Epidemiology of infection in mechanical circulatory support: a global analysis from the ISHLT Mechanically Assisted Circulatory Support Registry. J Heart Lung Transplant 38(4):364–373. https://doi.org/10.1016/j.healun.2019.01.007

    Article  PubMed  Google Scholar 

  • Houston BA, Shah KB, Mehra MR, Tedford RJ (2017) A new „twist“ on right heart failure with left ventricular assist systems. J Heart Lung Transplant 36(7):701–707. https://doi.org/10.1016/j.healun.2017.03.014

    Article  PubMed  Google Scholar 

  • Kirklin JK, Naftel DC, Pagani FD, Kormos RL, Stevenson LW, Blume ED, Miller MA, Baldwin JT, Young JB (2014) Sixth INTERMACS annual report: a 10,000-patient database. J Heart Lung Transplant 33(6):555–564. https://doi.org/10.1016/j.healun.2014.04.010

    Article  PubMed  Google Scholar 

  • Kavarana MN, Pessin-Minsley MS, Urtecho J, Catanese KA, Flannery M, Oz MC, Naka Y (2002) Right ventricular dysfunction and organ failure in left ventricular assist device recipients: a continuing problem. Ann Thorac Surg 73(3):745–750. https://doi.org/10.1016/s0003-4975(01)03406-3

    Article  PubMed  Google Scholar 

  • Kirklin JK, Naftel DC, Kormos RL, Stevenson LW, Pagani FD, Miller MA, Baldwin JT, Young JB (2013) Fifth INTERMACS annual report: risk factor analysis from more than 6,000 mechanical circulatory support patients. J Heart Lung Transplant 32(2):141–156. https://doi.org/10.1016/j.healun.2012.12.004

    Article  PubMed  Google Scholar 

  • Leuck A-M (2015) Left ventricular assist device driveline infections: recent advances and future goals. J Thorac Dis 7(12):2151–2157. https://doi.org/10.3978/j.issn.2072-1439.2015.11.06

    Article  PubMed  PubMed Central  Google Scholar 

  • Lietz K, Miller LW (2009) Patient selection for left-ventricular assist devices. Curr Opin Cardiol 24(3):246–251. https://doi.org/10.1097/HCO.0b013e32832a0743

    Article  PubMed  Google Scholar 

  • Lo Coco V, De Piero ME, Massimi G, Chiarini G, Raffa GM, Kowalewski M, Maessen J, Lorusso R (2021) Right ventricular failure after left ventricular assist device implantation: a review of the literature. J Thorac Dis 13(2):1256–1269. https://doi.org/10.21037/jtd-20-2228

    Article  PubMed  PubMed Central  Google Scholar 

  • Macris MP, Parnis SM, Frazier OH, Fuqua JM Jr, Jarvik RK (1997) Development of an implantable ventricular assist system. Ann Thorac Surg 63(2):367–370. https://doi.org/10.1016/s0003-4975(96)01226-x

    Article  PubMed  Google Scholar 

  • McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Bohm M, Burri H, Butler J, Celutkiene J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, CSP L, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A, Group ESCSD (2021) 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 42(36):3599–3726. https://doi.org/10.1093/eurheartj/ehab368

    Article  PubMed  Google Scholar 

  • McNamara N, Narroway H, Williams M, Brookes J, Farag J, Cistulli D, Bannon P, Marasco S, Potapov E, Loforte A (2021) Contemporary outcomes of continuous-flow left ventricular assist devices-a systematic review. Ann Cardiothorac Surg 10(2):186–208. https://doi.org/10.21037/acs-2021-cfmcs-35

    Article  PubMed  PubMed Central  Google Scholar 

  • Mehra MR, Uriel N, Naka Y, Cleveland JC Jr, Yuzefpolskaya M, Salerno CT, Walsh MN, Milano CA, Patel CB, Hutchins SW, Ransom J, Ewald GA, Itoh A, Raval NY, Silvestry SC, Cogswell R, John R, Bhimaraj A, Bruckner BA, Lowes BD, Um JY, Jeevanandam V, Sayer G, Mangi AA, Molina EJ, Sheikh F, Aaronson K, Pagani FD, Cotts WG, Tatooles AJ, Babu A, Chomsky D, Katz JN, Tessmann PB, Dean D, Krishnamoorthy A, Chuang J, Topuria I, Sood P, Goldstein DJ (2019) A fully magnetically levitated left ventricular assist device – final report. N Engl J Med 380(17):1618–1627. https://doi.org/10.1056/NEJMoa1900486

    Article  PubMed  Google Scholar 

  • Mehra MR, Cleveland JC Jr, Uriel N, Cowger JA, Hall S, Horstmanshof D, Naka Y, Salerno CT, Chuang J, Williams C, Goldstein DJ (2021) Primary results of long-term outcomes in the MOMENTUM 3 pivotal trial and continued access protocol study phase: a study of 2200 HeartMate 3 left ventricular assist device implants. Eur J Heart Fail. https://doi.org/10.1002/ejhf.2211

  • Miller LW, Pagani FD, Russell SD, John R, Boyle AJ, Aaronson KD, Conte JV, Naka Y, Mancini D, Delgado RM, MacGillivray TE, Farrar DJ, Frazier OH (2007) Use of a continuous-flow device in patients awaiting heart transplantation. N Engl J Med 357(9):885–896. https://doi.org/10.1056/NEJMoa067758

    Article  PubMed  Google Scholar 

  • Minami K, El-Banayosy A, Sezai A, Arusoglu L, Sarnowsky P, Fey O, Koerfer R (2000) Morbidity and outcome after mechanical ventricular support using Thoratec, Novacor, and HeartMate for bridging to heart transplantation. Artif Organs 24(6):421–426. https://doi.org/10.1046/j.1525-1594.2000.06621.x

    Article  PubMed  Google Scholar 

  • Molina EJ, Shah P, Kiernan MS, Cornwell WK, Copeland H, Takeda K, Fernandez FG, Badhwar V, Habib RH, Jacobs JP, Koehl D, Kirklin JK, Pagani FD, Cowger JA (2021) The society of thoracic surgeons intermacs 2020 annual report. Ann Thorac Surg 111(3):778–792. https://doi.org/10.1016/j.athoracsur.2020.12.038

    Article  PubMed  Google Scholar 

  • Numan L, Ramjankhan FZ, Oberski DL, Oerlemans M, Aarts E, Gianoli M, Van Der Heijden JJ, De Jonge N, Van Der Kaaij NP, Meuwese CL, Mokhles MM, Oppelaar AM, De Waal EEC, Asselbergs FW, Van Laake LW (2021) Propensity score-based analysis of long-term outcome of patients on HeartWare and HeartMate 3 left ventricular assist device support. ESC Heart Fail 8(2):1596–1603. https://doi.org/10.1002/ehf2.13267

    Article  PubMed  PubMed Central  Google Scholar 

  • Pagani FD, Miller LW, Russell SD, Aaronson KD, John R, Boyle AJ, Conte JV, Bogaev RC, MacGillivray TE, Naka Y, Mancini D, Massey HT, Chen L, Klodell CT, Aranda JM, Moazami N, Ewald GA, Farrar DJ, Frazier OH (2009) Extended mechanical circulatory support with a continuous-flow rotary left ventricular assist device. J Am Coll Cardiol 54(4):312–321. https://doi.org/10.1016/j.jacc.2009.03.055

    Article  PubMed  Google Scholar 

  • Pappalardo F, Schulte C, Pieri M, Schrage B, Contri R, Soeffker G, Greco T, Lembo R, Müllerleile K, Colombo A, Sydow K, De Bonis M, Wagner F, Reichenspurner H, Blankenberg S, Zangrillo A, Westermann D (2017) Concomitant implantation of Impella® on top of veno-arterial extracorporeal membrane oxygenation may improve survival of patients with cardiogenic shock. Eur J Heart Fail 19(3):404–412. https://doi.org/10.1002/ejhf.668

    Article  PubMed  Google Scholar 

  • Ponikowski P, Voors AA, Anker SD, Bueno H, JGF C, AJS C, Falk V, González-Juanatey JR, Harjola V-P, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, GMC R, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer P, Group ESD (2016) 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 37(27):2129–2200. https://doi.org/10.1093/eurheartj/ehw128

    Article  PubMed  Google Scholar 

  • Pozzi M, Giraud R, Tozzi P, Bendjelid K, Robin J, Meyer P, Obadia JF, Banfi C (2015) Long-term continuous-flow left ventricular assist devices (LVAD) as bridge to heart transplantation. J Thorac Dis 7(3):532–542. https://doi.org/10.3978/j.issn.2072-1439.2015.01.45

    Article  PubMed  PubMed Central  Google Scholar 

  • Ricklefs M, Hanke JS, Dogan G, Napp LC, Feldmann C, Haverich A, Schmitto JD (2018) Less invasive surgical approaches for left ventricular assist device implantation. Semin Thorac Cardiovasc Surg 30(1):1–6. https://doi.org/10.1053/j.semtcvs.2018.01.002

    Article  PubMed  Google Scholar 

  • Rose EA, Gelijns AC, Moskowitz AJ, Heitjan DF, Stevenson LW, Dembitsky W, Long JW, Ascheim DD, Tierney AR, Levitan RG, Watson JT, Meier P, Ronan NS, Shapiro PA, Lazar RM, Miller LW, Gupta L, Frazier OH, Desvigne-Nickens P, Oz MC, Poirier VL, Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure Study G (2001) Long-term use of a left ventricular assist device for end-stage heart failure. N Engl J Med 345(20):1435–1443. https://doi.org/10.1056/NEJMoa012175

    Article  PubMed  Google Scholar 

  • Schramm R, Zittermann A, Morshuis M, Schoenbrodt M, von Roessing E, von Dossow V, Koster A, Fox H, Hakim-Meibodi K, Gummert JF (2020) Comparing short-term outcome after implantation of the HeartWare® HVAD® and the Abbott® HeartMate 3®. ESC Heart Fail 7(3):908–914. https://doi.org/10.1002/ehf2.12649

    Article  PubMed  PubMed Central  Google Scholar 

  • Starling RC, Naka Y, Boyle AJ, Gonzalez-Stawinski G, John R, Jorde U, Russell SD, Conte JV, Aaronson KD, McGee EC Jr, Cotts WG, DeNofrio D, Pham DT, Farrar DJ, Pagani FD (2011) Results of the post-U.S. Food and Drug Administration-approval study with a continuous flow left ventricular assist device as a bridge to heart transplantation: a prospective study using the INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support). J Am Coll Cardiol 57(19):1890–1898. https://doi.org/10.1016/j.jacc.2010.10.062

    Article  PubMed  Google Scholar 

  • Starling RC, Estep JD, Horstmanshof DA, Milano CA, Stehlik J, Shah KB, Bruckner BA, Lee S, Long JW, Selzman CH, Kasirajan V, Haas DC, Boyle AJ, Chuang J, Farrar DJ, Rogers JG (2017) Risk assessment and comparative effectiveness of left ventricular assist device and medical management in ambulatory heart failure patients: the ROADMAP Study 2-Year Results. JACC. Heart Fail 5(7):518–527. https://doi.org/10.1016/j.jchf.2017.02.016

    Article  Google Scholar 

  • Stevenson LW, Pagani FD, Young JB, Jessup M, Miller L, Kormos RL, Naftel DC, Ulisney K, Desvigne-Nickens P, Kirklin JK (2009) INTERMACS profiles of advanced heart failure: the current picture. J Heart Lung Transplant 28(6):535–541. https://doi.org/10.1016/j.healun.2009.02.015

    Article  PubMed  Google Scholar 

  • Strueber M, Larbalestier R, Jansz P, Zimpfer D, Fiane AE, Tsui S, Simon A, Schmitto JD, Khaghani A, Wieselthaler GM, Najarian K, Schueler S (2014) Results of the post-market Registry to Evaluate the HeartWare Left Ventricular Assist System (ReVOLVE). J Heart Lung Transplant 33(5):486–491. https://doi.org/10.1016/j.healun.2014.01.856

    Article  PubMed  Google Scholar 

  • Timmons M, Welsh AC, Baruah D, Shahir K, Rubenstein J (2015) Right ventricular size assessed by cardiovascular MRI may predict mortality after left ventricular assist device placement. J Cardiovasc Magn Resonan 17(1):P181. https://doi.org/10.1186/1532-429X-17-S1-P181

    Article  Google Scholar 

  • Yoshioka D, Takayama H, Garan RA, Topkara VK, Han J, Kurlansky P, Yuzefpolskaya M, Colombo PC, Naka Y, Takeda K (2017) Contemporary outcome of unplanned right ventricular assist device for severe right heart failure after continuous-flow left ventricular assist device insertion. Interact Cardiovasc Thorac Surg 24(6):828–834. https://doi.org/10.1093/icvts/ivw409

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinik für Herzchirurgie, herzchirurgische Intensivmedizin und Thoraxchirurgie, Herzzentrum Köln, Köln, Deutschland

    Parwis B. Rahmanian

  2. Klinik und Poliklinik für Herzchirurgie, herzchirurgische Intensivmedizin und Thoraxchirurgie, Herzzentrum, Uniklinik Köln, Köln, Deutschland

    Thorsten Wahlers

Authors
  1. Parwis B. Rahmanian
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thorsten Wahlers
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Thorsten Wahlers .

Editor information

Editors and Affiliations

  1. Medizinische Klinik I – Kardiologie, Angiologie und Internistische Intensivmedizin, Uniklinik RWTH Aachen, Aachen, Deutschland

    Nikolaus Marx

  2. Kardiologie, Pneumologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum Köln Klinik III für Innere Medizin, Köln, Deutschland

    Erland Erdmann

Rights and permissions

Reprints and permissions

Copyright information

© 2023 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Rahmanian, P.B., Wahlers, T. (2023). Ventricular Assist Devices. In: Marx, N., Erdmann, E. (eds) Klinische Kardiologie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-62932-1_22

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-62932-1_22

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-62931-4

  • Online ISBN: 978-3-662-62932-1

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics

Search

Navigation