Skip to main content

Left Ventricular Assist Devices for Long-Term Circulatory Support

  • Chapter
  • First Online:
Management of Heart Failure

Abstract

Left ventricular assist devices (LVADs) have become an increasingly utilized therapy for advanced heart failure (HF) due to recent innovations in technology, which have led to significantly improved outcomes. With a rapidly aging population in the United States and industrialized world, it is expected that the prevalence and incidence of HF will continue to increase. It is estimated that there are currently between 110,000 and 280,000 adults in the United States alone with NYHA Class IIIB and Class IV HF that could potentially be candidates for LVAD therapy [1]. Currently, <5000 LVAD implants are being performed annually in the US so it appears that this therapy is significantly underutilized.

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

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
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

References

  1. Heart Disease and Stroke Statistics. Update. American Heart Association. 2014.

    Google Scholar 

  2. Miller LW, Keith AD, Pagani FD, et al. Extended mechanical circulatory support with a continuous-flow rotary left ventricular assist device. J Am Coll Cardiol. 2009;54(4):312–21.

    Article  PubMed  Google Scholar 

  3. Miller LW, Pagani FD, Russell SD, et al. Use of continuous-flow device in patients awaiting heart transplantation. N Engl J Med. 2007;357:885–96.

    Article  CAS  PubMed  Google Scholar 

  4. Slaughter MS. UNOS status of heart transplant patients supported with left ventricular assist device. Tex Heart Inst J. 2011;38(5):549–51.

    PubMed Central  PubMed  Google Scholar 

  5. Macini D, Lietz K. Selection of cardiac transplantation candidates in 2010. Circulation. 2010;122:173–83.

    Article  Google Scholar 

  6. Stevenson LW, Miller LW, et al. Left ventricular assist device as destination for patients undergoing intravenous inotropic therapy: a subset analysis from REMATCH. Circulation. 2004;110(8):975–81.

    Article  PubMed  Google Scholar 

  7. Rogers JG, Butler J, Lansman SL, et al. Chronic mechanical circulatory support for inotrope-dependent heart failure patients who are not transplant candidates: results of the INTrEPID trial. J Am Coll Cardiol. 2007;50(8):741–7.

    Article  PubMed  Google Scholar 

  8. Pagani FD, Patel HJ, Aaronson KD. Significant reduction in major LVAD device failures: comparison of the heartmate VE and XVE LVAD. J Heart Lung Transplant. 2003;22(1):S204.

    Article  Google Scholar 

  9. Rose EA, Geljin AC, Moskowitz AJ, et al. Long-term mechanical left ventricular assistance for end-stage heart failure. N Engl J Med. 2001;345:1435–43.

    Article  CAS  PubMed  Google Scholar 

  10. Slaughter MS, Silver MA, et al. Low incidence of neurogenic events during long-term support with the heartmate XVE left ventricular assist device. Tex Heart J. 2008;35(3):245–9.

    Google Scholar 

  11. Arabia FA, Copeland JG, et al. Total artificial hearts: bridge to transplantation. Cardiol Clin. 2003;21(1):101–13.

    Article  PubMed  Google Scholar 

  12. Kamdar JR, et al. Lessons learned from experience with over 100 consecutive heartmate II left ventricular assist devices. Ann Thorac Surg. 2011;92(5):1593–9.

    Article  PubMed  Google Scholar 

  13. Slaughter MS, Rogers JG, Milano CA, et al. Advanced heart failure treated with continuous-flow left ventricular assist device. N Engl J Med. 2009;361:2241–51.

    Article  CAS  PubMed  Google Scholar 

  14. LaRose J, Carlos A, et al. Design concepts and principle of operation of the HeartWare ventricular assist system. ASAIO J. 2010;56(4):285–9.

    PubMed  Google Scholar 

  15. McGee EC, Ahmad U, McCarthy P, et al. Biventricular circulatory support with two miniaturized implantable assist devices. Ann Thorac Surg. 2011;92(1):e1–3.

    Article  PubMed  Google Scholar 

  16. Aaronson KD, Slaughter MS, et al. Evaluation of the HeartWare HVAD left ventricular assist device system for the treatment of advanced heart failure: results of the ADVANCE bridge to transplant trial. Circulation. 2010;122:2216.

    Google Scholar 

  17. Slaughter MS, Pagani FD, et al. HeartWare ventricular assist system for bridge to transplant: combined results of the bridge to transplant and continued access protocol trial. J Heart Lung Transplant. 2013;32(7):675–83.

    Article  PubMed  Google Scholar 

  18. Copeland J. HeartWare ventricular assist system for bridge to transplant: the new kid on the block. J Heart Lung Transplant. 2013;32(7):671–2.

    Article  PubMed  Google Scholar 

  19. Boyle A, Kamdar F, John, et al. Improved survival and decreasing incidence of adverse events with the HeartMate II left ventricular assist device as bridge-to-transplant therapy. Ann Thorac Surg. 2008;86(4):1227–35.

    Article  PubMed  Google Scholar 

  20. Kirklin JK, Naftel DC, Kormos RL, et al. Second INTERMACS annual report: more than 1000 primary left ventricular assist device implants. J Heart Lung Transplant. 2010;29(1):1–10.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Hershberger RE, Nauman D, Walker TL, et al. Care processes and clinical outcomes of continuous outpatient support wit h inotropes (COSI) in patients with refractory end stage heart failure. J Card Fail. 2003;9:180–7.

    Article  PubMed  Google Scholar 

  22. Russell SD, Miller LW, Pagani FD. Advanced heart failure: a call to action. Congestive Heart Fail. 2008;14(6):316–21.

    Article  Google Scholar 

  23. Torre-Amione G, Southard RE, Loebe MM, et al. Reversal of secondary pulmonary hypertension by axial and pulsatile mechanical circulatory support. J Heart Lung Transplant. 2010;29(2):195–200.

    Article  PubMed  Google Scholar 

  24. Slaughter MS, Pagani FD, Miller LW, et al. Clinical management of continuous-flow left ventricular assist devices in advanced heart failure. J Heart Lung Transplant. 2010;29(4):S1–39.

    Article  PubMed  Google Scholar 

  25. John R, Pagani FD, Naka Y, Boyle A, et al. Post-cardiac transplant survival after support with a continuous-flow left ventricular assist device: impact of duration of left ventricular assist device support and other variables. J Thorac Cardiovasc Surg. 2010;140(1):174–81.

    Article  PubMed  Google Scholar 

  26. Dang NC, Topkara VK, Mercando M, et al. Right heart failure after left ventricular assist device implantation in patients with chronic congestive heart failure. J Heart Lung Transplant. 2006;25(1):1–6.

    Article  PubMed  Google Scholar 

  27. Fitzpatrick 3rd JR, Frederick JR, Hiesinger W, et al. Early planned institution of biventricular mechanical circulatory support results in improved outcomes compared with delayed conversion of a left ventricular assist device to a biventricular assist device. J Thorac Cardiovasc Surg. 2009;137(4):971–7.

    Article  PubMed Central  PubMed  Google Scholar 

  28. Matthews JC, Koelling TM, Pagani FD, Aaronson KD. The right ventricular failure risk score: a pre-operative toll for assessing the risk of ventricular failure in left ventricular assist device candidates. J Am Coll Cardiol. 2008;51:2163–72.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Fitzpatrick 3rd JR, Frederick JR, Hsu VM, et al. Risk score derived from pre-operative data analysis predicts the need for biventricular mechanical circulatory support. J Heart Lung Transplant. 2008;27(12):1286–92.

    Article  PubMed Central  PubMed  Google Scholar 

  30. Lietz K, Long JW, Kfoury AG, et al. Outcomes of left ventricular assist device implantation as destination therapy in the post-REMATCH era: implications for patient selection. Circulation. 2007;116:497–505.

    Article  PubMed  Google Scholar 

  31. Starling RC, Naka Y, Pagani FD, et al. Result of the post-U.S. Food and Drug Administration approved study with a continuous flow left ventricular assist device as a bridge to heart transplantation; a prospective study using the INTERMACS. J Am Coll Cardiol. 2011;57(19):1890–8.

    Article  PubMed  Google Scholar 

  32. Singh A, Russo MJ, Valeroso TB, et al. Modified HeartMate II driveline externalization technique significantly decreases incidence of infection and improves long-term survival. ASAIO J. 2014. (In press).

    Google Scholar 

  33. Mangi AA. Right ventricular dysfunction in patients undergoing left ventricular assist device implantation: predictors, management, and device utilization. Cardiol Clin. 2011;29(4):629–37.

    Article  PubMed  Google Scholar 

  34. Starling RC, Silvestry SC, Rogers JG, Milano CA, et al. Unexpected abrupt increase in left ventricular assist device thrombosis. N Engl J Med. 2014;370(1):33–40.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Abbasali S. Badami MBBS .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer-Verlag London Ltd.

About this chapter

Cite this chapter

Badami, A.S., Akhter, S.A. (2016). Left Ventricular Assist Devices for Long-Term Circulatory Support. In: Raman, J. (eds) Management of Heart Failure. Springer, London. https://doi.org/10.1007/978-1-4471-4279-9_11

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-4279-9_11

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4278-2

  • Online ISBN: 978-1-4471-4279-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics