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Implication of Hemodynamic Assessment during Durable Left Ventricular Assist Device Support
Durable left ventricular assist device therapy has improved survival in patients with advanced heart failure refractory to conventional medical therapy, although the readmission rates due to device-related comorbidities remain high. Left ventricular assist devices are designed to support a failing l...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7466331/ https://www.ncbi.nlm.nih.gov/pubmed/32824131 http://dx.doi.org/10.3390/medicina56080413 |
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author | Imamura, Teruhiko Narang, Nikhil |
author_facet | Imamura, Teruhiko Narang, Nikhil |
author_sort | Imamura, Teruhiko |
collection | PubMed |
description | Durable left ventricular assist device therapy has improved survival in patients with advanced heart failure refractory to conventional medical therapy, although the readmission rates due to device-related comorbidities remain high. Left ventricular assist devices are designed to support a failing left ventricle through relief of congestion and improvement of cardiac output. However, many patients still have abnormal hemodynamics even though they may appear to be clinically stable. Furthermore, such abnormal hemodynamics are associated with an increased risk of future adverse events including recurrent heart failure, gastrointestinal bleeding, stroke, and pump thrombosis. Correction of residual hemodynamic derangements post-implantation may be a target in improving longitudinal clinical outcomes during left ventricular assist device support. Automatic and timely device speed adjustments considering a patients’ hemodynamic status (i.e., with a smart pump) are potential improvements in forthcoming devices. |
format | Online Article Text |
id | pubmed-7466331 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-74663312020-09-14 Implication of Hemodynamic Assessment during Durable Left Ventricular Assist Device Support Imamura, Teruhiko Narang, Nikhil Medicina (Kaunas) Review Durable left ventricular assist device therapy has improved survival in patients with advanced heart failure refractory to conventional medical therapy, although the readmission rates due to device-related comorbidities remain high. Left ventricular assist devices are designed to support a failing left ventricle through relief of congestion and improvement of cardiac output. However, many patients still have abnormal hemodynamics even though they may appear to be clinically stable. Furthermore, such abnormal hemodynamics are associated with an increased risk of future adverse events including recurrent heart failure, gastrointestinal bleeding, stroke, and pump thrombosis. Correction of residual hemodynamic derangements post-implantation may be a target in improving longitudinal clinical outcomes during left ventricular assist device support. Automatic and timely device speed adjustments considering a patients’ hemodynamic status (i.e., with a smart pump) are potential improvements in forthcoming devices. MDPI 2020-08-15 /pmc/articles/PMC7466331/ /pubmed/32824131 http://dx.doi.org/10.3390/medicina56080413 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Imamura, Teruhiko Narang, Nikhil Implication of Hemodynamic Assessment during Durable Left Ventricular Assist Device Support |
title | Implication of Hemodynamic Assessment during Durable Left Ventricular Assist Device Support |
title_full | Implication of Hemodynamic Assessment during Durable Left Ventricular Assist Device Support |
title_fullStr | Implication of Hemodynamic Assessment during Durable Left Ventricular Assist Device Support |
title_full_unstemmed | Implication of Hemodynamic Assessment during Durable Left Ventricular Assist Device Support |
title_short | Implication of Hemodynamic Assessment during Durable Left Ventricular Assist Device Support |
title_sort | implication of hemodynamic assessment during durable left ventricular assist device support |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7466331/ https://www.ncbi.nlm.nih.gov/pubmed/32824131 http://dx.doi.org/10.3390/medicina56080413 |
work_keys_str_mv | AT imamurateruhiko implicationofhemodynamicassessmentduringdurableleftventricularassistdevicesupport AT narangnikhil implicationofhemodynamicassessmentduringdurableleftventricularassistdevicesupport |