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Evolution of Left Ventricular Assist Device Therapy for Advanced Heart Failure: A Review
Leslie W Miller1, Joseph G Rogers2
1Texas Heart Institute, Houston.
JAMA Cardiology
|May 1, 2018
Summary
Left ventricular assist devices (LVADs) significantly improve survival for advanced heart failure patients. Ongoing innovations aim to further enhance outcomes and patient satisfaction, addressing current complications.
Area of Science:
- Cardiology and Mechanical Circulatory Support
- Advanced Heart Failure Management
Background:
- High mortality rates persist for advanced heart failure despite medical therapy.
- Left ventricular assist devices (LVADs) are increasingly vital in managing these patients.
Purpose of the Study:
- To review the advancements in LVAD therapy over the past 15 years.
- To highlight key aspects including patient selection, device evolution, complications, and outcomes.
Main Methods:
- Comprehensive literature review of English-language articles published in the last 15 years.
- Focused search on advanced heart failure and LVADs, including clinical trials, cohort studies, and registry data.
Main Results:
- Significant progress in LVAD therapy: improved patient selection, device design (continuous flow, smaller, durable), and postoperative care.
- Mean survival post-LVAD implantation is approximately 5 years.
- Complications such as bleeding, infection, pump thrombosis, and stroke remain challenges.
Conclusions:
- LVADs represent a critical advancement in mechanical circulatory support for end-stage heart failure.
- Continued innovation is expected to improve outcomes and patient satisfaction.
- Healthcare professionals must be aware of LVAD progress to effectively manage heart failure patients.
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