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Download Left Ventricular Assist Devices: A Primer
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Transcript
Left Ventricular Assist Devices: The What and the Who Lance E. Sullenberger MD FACC FACP Capital Cardiology Associates But USHeart HeartFailure Transplants Increasing… Stable Left Ventricular Assist Device Pulsatile Flow • Not a true artificial heart. • Assists the left ventricle in passing oxygenated blood through the body. • Initially was a pulsatile device (similar to native heart…) Left Ventricular Assist Device Continuous (Axial) Flow Pulsatile Flow is Out Axial Flow is In The Down Side • • • • • • Infection Bleeding Thrombosis Embolism Battery issues Hemolysis Who Gets an LVAD? • Bridge to Recovery • Bridge to Transplant • Destination Therapy Bridge to Recovery • Acute Myocarditis • Acute Myocardial Infarction • Peripartum Cardiomyopathy • Younger • Previously healthy • Few comorbidities Bridge to Transplant Destination Therapy REMATCH Trial • •Can’t a TX 129get patients – Older • Ineligible for cardiac – Hepatitis transplant – DM with small vessel • Class IV CHF disease ½ received • •Might not getLVAD a TX issues medical • –½Renal received –therapy PHTN alone • Complex surgical Warning Signs!! Inability to Take CHF Therapy Low Sodium Cardiorenal Syndrome Warning Signs! Recurrent Admissions Low Blood Pressure Hyponatremia Poor Renal Function Use of Continuous Inotropes • Increasing diuretic dose • Worsening Heart Failure Class • • • • • Bring It Home…. Thank You!!! LANCE SULLENBERGER MD [email protected]
