Review
Medicine, General & Internal
Gregory S. Troutman, Michael Genuardi
Summary: Survival rates for patients with end-stage heart failure continue to improve after implantation of a left ventricular assist device (LVAD). More patients are opting for long-term treatment with LVADs rather than bridge-to-transplant therapy, therefore it is crucial for healthcare providers to be familiar with the physiology, operation, and common complications of these devices. This review article provides an overview of the history, development, and operation of modern LVADs, as well as a discussion of common complications and suggested approaches to LVAD patients.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Daniel Burkhoff, Veli K. Topkara, Gabriel Sayer, Nir Uriel
Summary: This review provides a comprehensive overview of research into LVAD therapy for heart failure, including the hemodynamic effects of LVAD support and the structural, cellular, and molecular aspects of LVAD-associated reverse remodeling. The review also discusses the synergistic effects of LVAD support with heart failure therapies on clinical outcomes and myocardial biology.
CIRCULATION RESEARCH
(2021)
Article
Cardiac & Cardiovascular Systems
Mahmood Abu Akel, Aviv A. Shaul, Gustavo R. Goldenberg, Yaron D. Barac, Binyamin Ben-Avraham, Dan Gorfil, Dan Aravot, Tuvia Ben-Gal
Summary: This case report describes the successful heart transplantation of a patient with ventricular arrhythmia who was treated with combined LVAD and VA ECMO, effectively controlling heart failure and achieving good clinical outcomes.
Article
Cardiac & Cardiovascular Systems
Guillaume Baudry, Nicolas Nesseler, Erwan Flecher, Andre Vincentelli, Celine Goeminne, Clement Delmas, Jean Porterie, Karine Nubret, Mathieu Pernot, Michel Kindo, Tam Hoang Minh, Philippe Rouviere, Philippe Gaudard, Magali Michel, Thomas Senage, Aude Boignard, Olivier Chavanon, Marylou Para, Constance Verdonk, Edeline Pelce, Vlad Gariboldi, Frederic Anselme, Pierre-Yves Litzler, Katrien Blanchart, Gerard Babatasi, Marie Bielefeld, Olivier Bouchot, David Hamon, Nicolas Lellouche, Xavier Bailleul, Thibaud Genet, Romain Eschalier, Nicolas d'Ostrevy, Marie-Cecile Bories, Ramzi Abi Akar, Hugues Blangy, Fabrice Vanhuyse, Jean Francois Obadia, Vincent Galand, Matteo Pozzi
Summary: Despite updated guidelines, there is still a delay in referring advanced heart failure patients for mechanical circulatory support and transplants. This study analyzed the characteristics and outcomes of non-inotrope-dependent patients with LVAD, finding unsatisfactory survival rates. Age, concomitant procedures, and temporary mechanical right ventricular support during LVAD implantation were identified as independent variables associated with mortality.
Review
Cardiac & Cardiovascular Systems
Selim R. Krim, Amanda Bennett, Michael Pfeffer, Patrick T. Campbell, Steven Thai, Brooke Baetz, James Wever-Pinzon, Clement Eiswirth, Sapna Desai, Hector O. Ventura
Summary: Data on the efficacy and safety of combination therapy with warfarin and dual antiplatelet therapy compared to warfarin and mono antiplatelet therapy in LVAD patients is limited. This single-center study found that the risk of pump thrombosis was lower at 1-year in patients receiving dual antiplatelet therapy, but there were no significant differences in bleeding, stroke, or survival.
CURRENT PROBLEMS IN CARDIOLOGY
(2022)
Article
Cardiac & Cardiovascular Systems
Anubodh S. Varshney, Ersilia M. DeFilippis, Jennifer A. Cowger, Ivan Netuka, Sean P. Pinney, Michael M. Givertz
Summary: With the increasing prevalence of advanced heart failure, treatment options such as heart transplantation and LVAD support have shown to improve quality of life and extend survival. Recent advancements, including the use of HeartMate 3 in clinical practice and revisions to the organ allocation system, have led to better management of LVAD-related complications. Although contemporary LVAD recipients have higher illness severity preoperatively, they have higher survival rates and lower adverse event rates compared to previous eras. However, challenges such as bleeding, infection, neurologic events, and right ventricular failure still limit the wider implementation of LVAD support. Ongoing efforts to optimize management of current LVAD devices and develop next-generation devices are expected to further enhance outcomes for patients with advanced heart failure.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2022)
Review
Cardiac & Cardiovascular Systems
Sunit-Preet Chaudhry, Adam D. DeVore, Himabindu Vidula, Michael Nassif, Karol Mudy, Edo Y. Birati, Timothy Gong, Pavan Atluri, Duc Pham, Benjamin Sun, Aditya Bansal, Samer S. Najjar
Summary: This review provides an overview of durable LVADs, discussing patient selection and the basic principles of LVAD care. It also covers common complications associated with LVAD therapy. The goal is to help general cardiologists recognize potential LVAD candidates and understand the principles of managing LVAD patients.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2022)
Review
Medicine, General & Internal
Alessia Gambaro, Gianmarco Lombardi, Francesco Onorati, Leonardo Gottin, Flavio Luciano Ribichini
Summary: LVAD implantation has complex effects on the kidneys, particularly regarding renal function. Creatinine-based eGFR formulas help in assessing patient prognosis, while deterioration in renal function in LVAD patients negatively impacts outcomes.
EUROPEAN JOURNAL OF CLINICAL INVESTIGATION
(2021)
Article
Cardiac & Cardiovascular Systems
Dominic Emerson, Joanna Chikwe, Pedro Catarino, Mohamed Hassanein, Luqin Deng, Ryan S. Cantor, Amy Roach, Robert Cole, Fardad Esmailian, Jon Kobashigawa, Jaime Moriguchi, James K. Kirklin
Summary: In contemporary practice, elderly patients receiving LVADs showed improved survival, increased functional capacity, enhanced quality of life, and fewer complications compared with younger patients.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2021)
Review
Cardiac & Cardiovascular Systems
Maria Generosa Crespo-Leiro, Maria Rosa Costanzo, Finn Gustafsson, Kiran K. Khush, Peter S. Macdonald, Luciano Potena, Josef Stehlik, Andreas Zuckermann, Mandeep R. Mehra
Summary: Heart transplantation faces challenges including limited organ pool, personalized immunosuppressive therapy, and minimizing late complications. Advances such as using hepatitis C-infected donors, expanding donor source, and new preservation techniques have increased organ availability. Mechanical circulatory support has helped patients with advanced heart failure maintain organ function while waiting for a suitable donor match.
EUROPEAN HEART JOURNAL
(2022)
Editorial Material
Cardiac & Cardiovascular Systems
Masashi Kawabori, Taylor Nordan, Navin K. Kapur, Gregory S. Couper
Summary: Right ventricular failure has a negative impact on prognosis post left ventricular assist device implantation. However, a strategy for primary prevention of right ventricular failure in high-risk patients has been proposed.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2021)
Article
Cardiac & Cardiovascular Systems
Nicole K. Bart, Desire Robson, Kavitha Muthiah, Paul C. Jansz, Christopher S. Hayward
Summary: This study aimed to determine the frequency and outcomes of autopsy investigations in patients who died prior to heart transplantation after receiving permanent mechanical circulatory support.
JOURNAL OF HEART AND LUNG TRANSPLANTATION
(2023)
Article
Cardiac & Cardiovascular Systems
Douglas Darden, Enrico Ammirati, Michela Brambatti, Andrew Lin, Jonathan C. Hsu, Palak Shah, Enrico Perna, Maja Cikes, Grunde Gjesdal, Luciano Potena, Marco Masetti, Nina Jakus, Caroline Van De Heyning, Dina De Bock, Jasper J. Brugts, Claudio F. Russo, Jesse F. Veenis, Filip Rega, Manlio Cipriani, Maria Frigerio, Klein Liviu, Kimberly N. Hong, Eric Adler, Oscar O. Braun
Summary: Observational data from a multinational registry of LVAD patients showed that different types of CIED did not have a significant impact on survival rates, but patients with a pre-existing CRT-D had a higher risk of late right ventricular failure.
INTERNATIONAL JOURNAL OF CARDIOLOGY
(2021)
Review
Nutrition & Dietetics
Gennaro Martucci, Federico Pappalardo, Harikesh Subramanian, Giulia Ingoglia, Elena Conoscenti, Antonio Arcadipane
Summary: Heart failure remains a major global cause of morbidity, hospitalization, and mortality. Advances in LVAD technology offer hope for HF patients, but research and attention to endocrine function are also crucial.
Review
Cardiac & Cardiovascular Systems
Claudio A. Bravo, Andrew G. Navarro, Karanpreet K. Dhaliwal, Maziar Khorsandi, Jeffrey E. Keenan, Parvathi Mudigonda, Kevin D. O'Brien, Claudius Mahr
Summary: Left ventricular assist device (LVAD) therapy is a life-saving option for patients with advanced heart failure who do not respond to medical treatment. However, a significant percentage of LVAD patients develop right heart failure (RHF), which is associated with poor outcomes. The mechanisms of RHF are complex, involving patient factors, surgical factors, and hemodynamic factors. Despite advances in surgical techniques and LVAD technology, RHF remains a major cause of morbidity and mortality among LVAD patients. Current medical therapies for RHF are limited, and cardiac transplantation or supportive management are the only options for these patients. Efforts to predict the risk of RHF in LVAD patients have been challenging, with varying definitions of RHF in different studies. Additionally, most research in this field has focused on early-onset RHF, while late-onset RHF is increasingly recognized as a significant problem. This review aims to describe the unique physiology of the right ventricle and the changes caused by LVADs that may contribute to both early- and late-onset RHF. The available treatments for RHF, including mechanical circulatory support and medical therapies, will also be analyzed.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Roland Hetzer, Takeshi Komoda, Satuski Komoda, Felix Berger, Michael Huebler
ANNALS OF THORACIC SURGERY
(2010)
Editorial Material
Cardiac & Cardiovascular Systems
Takeshi Komoda, Satsuki Komoda, Petra Gehle, Felix Berger, Robert Hammerschmidt, Roland Hetzer, Michael Huebler
ANNALS OF THORACIC SURGERY
(2013)
Article
Cardiac & Cardiovascular Systems
Takeshi Komoda, Alexander Frumkin, Christoph Knosalla, Roland Hetzer
ANNALS OF THORACIC SURGERY
(2013)
Article
Cardiac & Cardiovascular Systems
Takeshi Komoda, Thorsten Drews, Roland Hetzer, Hans B. Lehmkuhl
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2011)
Article
Cardiac & Cardiovascular Systems
Boris A. Nasseri, Christof Stamm, Henryk Siniawski, Marian Kukucka, Takeshi Komoda, Eva M. Delmo Walter, Roland Hetzer
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2011)
Article
Cardiac & Cardiovascular Systems
Eva Maria Delmo Walter, Takeshi Komoda, Henryk Siniawski, Oliver Miera, Richard Van Praagh, Roland Hetzer
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2013)
Article
Cardiac & Cardiovascular Systems
Roland Hetzer, Takeshi Komoda, Eva Maria Delmo Walter
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2013)
Article
Cardiac & Cardiovascular Systems
Takeshi Komoda, Thorsten Drews, Roland Hetzer, Hans B. Lehmkuhl
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2013)
Article
Cardiac & Cardiovascular Systems
Satsuki Komoda, Takeshi Komoda, Wilko Weichert, Roland Hetzer
JOURNAL OF CARDIAC SURGERY
(2009)
Article
Cardiac & Cardiovascular Systems
Takeshi Komoda, Thorsten Drews, Roland Hetzer, Hans B. Lehmkuhl
JOURNAL OF HEART AND LUNG TRANSPLANTATION
(2010)
Article
Cardiac & Cardiovascular Systems
Eva Maria Delmo Walter, Takeshi Komoda, Henryk Siniawski, Roland Hetzer
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2012)
Article
Cardiac & Cardiovascular Systems
Takeshi Komoda, Christof Stamm, Eckart Fleck, Roland Hetzer
INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY
(2012)
Article
Cardiac & Cardiovascular Systems
Satsuki Komoda, Takeshi Komoda, Marianne E. Pavel, Lars Morawietz, Bertram Wiedenmann, Roland Hetzer, Hans B. Lehmkuhl
GENERAL THORACIC AND CARDIOVASCULAR SURGERY
(2011)
Article
Cardiac & Cardiovascular Systems
Nicole Nagdyman, Peter Ewert, Takeshi Komoda, Vladimir Alexi-Meskisvili, Yuguo Weng, Felix Berger, Roland Hetzer
JOURNAL OF HEART VALVE DISEASE
(2010)
Article
Cardiac & Cardiovascular Systems
Satsuki Komoda, Takeshi Komoda, Ekaterina Ivanitskaia-Kuehn, Stephan Dreysse, Miralem Pasic, Roland Hetzer
GENERAL THORACIC AND CARDIOVASCULAR SURGERY
(2010)