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Related Concept Videos

Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

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Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
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Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

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Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
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Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

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Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
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Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

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Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
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Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

220
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
220
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

147
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
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Related Experiment Video

Updated: Nov 19, 2025

Use of Two Intracorporeal Ventricular Assist Devices As a Total Artificial Heart
08:49

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Using existing technology better: Improving outcomes with the HeartWare left ventricular assist device.

Guy A MacGowan1, Andrew Woods1, Nicola Robinson-Smith1

  • 1Departments of Cardiology, Cardiothoracic Surgery and Anaesthesia, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, and Newcastle University Biosciences Institute, Newcastle upon Tyne, NE7 7DN, UK.

International Journal of Cardiology
|February 2, 2021
PubMed
Summary

Improved patient selection and use of temporary right ventricular assist devices significantly boosted survival rates for HeartWare left ventricular assist device recipients. However, intracranial hemorrhage, sepsis, and right heart failure remain critical challenges.

Keywords:
OutcomesVentricular assist device

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Area of Science:

  • Cardiology
  • Medical Devices
  • Clinical Outcomes

Background:

  • The HeartWare left ventricular assist device (LVAD) has been clinically utilized for over a decade.
  • Assessing temporal trends in LVAD outcomes is crucial for refining patient care.

Purpose of the Study:

  • To evaluate the evolution of outcomes for patients receiving the HeartWare LVAD at a single center over time.
  • To identify factors contributing to improvements in survival and complications.

Main Methods:

  • A retrospective review of electronic hospital records was conducted at the Freeman Hospital.
  • 255 adult patients receiving their first HeartWare LVAD implant were analyzed, divided into two eras: 2009-2015 (Era 1) and 2016-2020 (Era 2).
  • Patient selection criteria, specifically Intermacs Classification, were prospectively modified in Era 2 to include lower-risk patients.

Main Results:

  • A significant shift towards lower-risk Intermacs classifications was observed in Era 2 (P < 0.001).
  • One-year survival improved significantly from 70% in Era 1 to 80% in Era 2 (P < 0.05), primarily due to reduced 30-day mortality (1.7% vs 15.5%, P < 0.005).
  • Improved right ventricular function and increased use of temporary right ventricular assist devices were noted in Era 2, though deaths from intracranial hemorrhage, sepsis, and right heart failure remained unchanged.

Conclusions:

  • Enhanced patient selection and increased utilization of temporary right ventricular support have demonstrably improved survival rates for LVAD patients.
  • Despite survival gains, intracranial hemorrhage, sepsis, and right heart failure continue to pose significant clinical challenges requiring further attention.