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Clinical choices for circulatory assist devices
1Department of Cardiothoracic Surgery, University of California, Irvine.
ASAIO Transactions
|October 1, 1990
Summary
Ventricular assist devices (VADs) offer solutions for patients unable to wean from bypass or awaiting transplants. Understanding VAD system strengths and limitations is crucial for successful patient outcomes.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Medical Devices
Background:
- 1.0% of open-heart surgery patients cannot be weaned from cardiopulmonary bypass.
- Nearly 20% of cardiac transplant candidates die while awaiting a donor heart.
- Pulsatile pneumatic ventricular assist devices (VADs) present a viable solution for these critical patient populations.
Purpose of the Study:
- To review the competitive landscape of VAD systems.
- To highlight the importance of understanding individual VAD system strengths and limitations.
- To emphasize optimal patient selection and management for VADs.
Main Methods:
- Comparative analysis of five leading VAD manufacturers (Novacor, Thermetics, Thoratec, Symbion, Abiomed).
- Review of clinical applications, including bridge to transplantation and ventricular recovery.
- Discussion of critical management aspects: patient selection, anticoagulation, and complication handling.
Main Results:
- Five major manufacturers offer competitive VAD systems.
- No single VAD system is universally optimal for all patients.
- Successful VAD utilization requires careful patient selection and management.
Conclusions:
- Knowledge of VAD system specifics is essential for improving patient outcomes.
- Strict patient selection criteria are paramount for VAD success.
- Effective VAD management involves meticulous anticoagulation and prompt complication treatment.