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Outcome Through the Years of Left-Ventricular Assist Devices Therapy for End-Stage Heart Failure: A Review
Ilaria Tropea1, Giovanni Domenico Cresce1, Valerio Sanesi1
1Cardiovascular Department, S. Bortolo Hospital, 36100 Vicenza, Italy.
Insights
Left ventricular assist devices (LVADs) support advanced heart failure patients when transplants aren't possible. Newer devices reduce complications, improving patient management and quality of life.
Area of Science:
- Cardiology
- Medical Devices
- Surgical Treatment
Background:
- Heart transplantation is the gold standard for advanced heart failure.
- Medical therapies offer improved survival and quality of life but may be insufficient.
- Limited donor availability and transplant criteria increase reliance on mechanical circulatory support, like LVADs.
Purpose of the Study:
- To review the primary complications in patients with LVADs.
- To outline daily management strategies for LVAD patients.
Main Methods:
- Literature review of LVAD complications and management.
- Analysis of long-term outcomes and device advancements.
Main Results:
- LVAD patients often have comorbidities, increasing vulnerability.
- Common complications include bleeding, infections, neurological events, and RV dysfunction.
- Advancements in biocompatible LVADs have reduced complication rates.
Conclusions:
- LVADs are crucial for managing advanced heart failure.
- Ongoing monitoring and management are essential for LVAD recipients.
- Improved device technology enhances patient outcomes and reduces complications.
Abstract:
Heart transplantation remains the gold standard surgical treatment for advanced heart failure. Over time, medical therapies have achieved remarkable outcomes in terms of survival and quality of life, yet their results may be insufficient, even when maximized. The limited availability of organ donors and the selective criteria for heart transplant eligibility have led to a significant rise in the utilization of long-term mechanical circulatory support, including left ventricular assist devices. Patients receiving LVADs often present with multiple comorbidities, constituting a highly vulnerable population. Individuals living with LVADs may experience various long-term complications, such as bleeding, driveline infections, neurological events, and right ventricular dysfunction. Fortunately, the development of increasingly biocompatible LVAD devices in recent years has resulted in a notable reduction in these complications. This review aims to summarize the principal complications encountered by patients with LVADs throughout their treatment and the associated daily management strategies.
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