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Ventricular assist devices for heart failure

BACKGROUND: Heart failure is a clinical syndrome of major epidemiological and economical importance. In Germany as in other industrialised countries it is one of the leading causes of mortality, morbidity and disability. For patients not responding to medical therapies ventricular assist devices are...

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Autores principales: Angermayr, Lucia, Velasco Garrido, Marcial, Busse, Reinhard
Formato: Texto
Lenguaje:English
Publicado: German Medical Science GMS Publishing House 2007
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3011328/
https://www.ncbi.nlm.nih.gov/pubmed/21289944
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author Angermayr, Lucia
Velasco Garrido, Marcial
Busse, Reinhard
author_facet Angermayr, Lucia
Velasco Garrido, Marcial
Busse, Reinhard
author_sort Angermayr, Lucia
collection PubMed
description BACKGROUND: Heart failure is a clinical syndrome of major epidemiological and economical importance. In Germany as in other industrialised countries it is one of the leading causes of mortality, morbidity and disability. For patients not responding to medical therapies ventricular assist devices are used as bridge to transplant, bridge to recovery or as destination therapy alternative to transplantation. RESEARCH QUESTIONS: This report aims to present the actual evidence on clinical effectiveness, psychological and social aspects and economical aspects of left ventricular assist devices. METHODS: We conducted a systematic research of the literature in different databases (EMBASE, MEDLINE, Cochrane Library). The included studies were assessed by two reviewers and were presented in tables and in a narrative form. We also conducted a survey among hospitals using the technology. RESULTS AND DISCUSSION: We included 40 references, six of them were HTA-reports. LVAD patients as bridge to transplant had better survival rates and a better quality of life as compared to medical therapy. Mechanical assistance was associated with frequent and often serious adverse events which were often the cause of death. There were numerous psychological and psychiatric problems. CONCLUSIONS/RECOMMENDATIONS: LVAD showed to be clinically effective, however with high complications rate and seriousness of them. The use of technology is very costly. Cost-effective should be analysed for Germany. There is a need to further develop the technology before it can contribute seriously to a reduction of the need for heart transplantation.
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spelling pubmed-30113282011-02-02 Ventricular assist devices for heart failure Angermayr, Lucia Velasco Garrido, Marcial Busse, Reinhard GMS Health Technol Assess Article BACKGROUND: Heart failure is a clinical syndrome of major epidemiological and economical importance. In Germany as in other industrialised countries it is one of the leading causes of mortality, morbidity and disability. For patients not responding to medical therapies ventricular assist devices are used as bridge to transplant, bridge to recovery or as destination therapy alternative to transplantation. RESEARCH QUESTIONS: This report aims to present the actual evidence on clinical effectiveness, psychological and social aspects and economical aspects of left ventricular assist devices. METHODS: We conducted a systematic research of the literature in different databases (EMBASE, MEDLINE, Cochrane Library). The included studies were assessed by two reviewers and were presented in tables and in a narrative form. We also conducted a survey among hospitals using the technology. RESULTS AND DISCUSSION: We included 40 references, six of them were HTA-reports. LVAD patients as bridge to transplant had better survival rates and a better quality of life as compared to medical therapy. Mechanical assistance was associated with frequent and often serious adverse events which were often the cause of death. There were numerous psychological and psychiatric problems. CONCLUSIONS/RECOMMENDATIONS: LVAD showed to be clinically effective, however with high complications rate and seriousness of them. The use of technology is very costly. Cost-effective should be analysed for Germany. There is a need to further develop the technology before it can contribute seriously to a reduction of the need for heart transplantation. German Medical Science GMS Publishing House 2007-10-31 /pmc/articles/PMC3011328/ /pubmed/21289944 Text en Copyright © 2007 Angermayr et al. http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free to copy, distribute and transmit the work, provided the original author and source are credited.
spellingShingle Article
Angermayr, Lucia
Velasco Garrido, Marcial
Busse, Reinhard
Ventricular assist devices for heart failure
title Ventricular assist devices for heart failure
title_full Ventricular assist devices for heart failure
title_fullStr Ventricular assist devices for heart failure
title_full_unstemmed Ventricular assist devices for heart failure
title_short Ventricular assist devices for heart failure
title_sort ventricular assist devices for heart failure
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3011328/
https://www.ncbi.nlm.nih.gov/pubmed/21289944
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