This concensus statement reviews the unique physiology, insertion techniques, and clinical indications for use of percutaneous mechanical circulatory support devices. As the options for management of different etiologies of heart failure in adult and pediatric populations expand, understanding the advantages of specific devices is vital.
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VAD
Evolution and Impact of Ventricular Assist Device Program on Children Awaiting Heart Transplantation
February 2, 2015
This single instutition study evaluated the impact of mechanical support in children awaiting heart transplant, comparing the pre-support era (1995-2005 and the post-support era (2005-2013); the latter era marked the transition to being able to provide support without concern for pt size. Support increased from 13% to 37%. Wait list mortality was d
January 25, 2015
This study from the University of Texas Southwestern sought to analyze the effects of mechanical unloading during prolonged LVAD support on mitochondrial mass, DNA damage response (DDR), and cardiomyocyte proliferation. Ten matched human samples of LV myocardium were analyzed before and after mechanical circulatory support.
January 17, 2015
The authors perform a meta-analysis of the limited studies available on the utility of tricuspid valve surgery in patients with significant TR at the time of LVAD implantation. No RCTs are available on this issue; however, six observational studies were analyzed by the group.
December 15, 2014
The CardioWest Total Artificial Heart (CW-TAH) is a pneumatically driven pump that completely replaces the patient’s native ventricles orthotopically.
December 13, 2014
This publication by the University of Louisville group provides an excellent comparative analysis of the outcomes after continuous-flow (CF) vs. pulsatile flow (PF) LVADs. Although the outcomes after CF LVAD implantation are clearly superior than those of PF LVADs, there are certainly unique morbidities after CF LVAD implantation.
December 11, 2014
In this Duke study, all CF LVAD implantations during the 2005 to 2013 era were analyzed, and those patients who underwent CF LVAD implantation and later replacement were reviewed.
November 15, 2014
Selzman and colleagues provide an outstanding overview of the state of the art of bridge to recovery, describing a paradigm shift that has been occurring. A consistent theme over the years is that recovery likelihood is enhanced in younger patients, those with non-ischemic cardiomyopathy, and those who have had HF for shorter durations.
November 13, 2014
The authors describe an alternative technique for insertion of a temporary RVAD so as to allow minimally invasive removal without sternotomy after RV recovery. An elongated graft is sewn to the PA and exited in the subxyphoid area at a site that is separate from the sternotomy incision. After exiting, the graft is attached to an outflow cannula.
November 10, 2014
The effects of exercise, increasing pump speed, or both on invasive hemodynamics in centrifugal flow LVAD patients were analyzed in this small study. Findings included: