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Related Concept Videos

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

321
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
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Heart Failure Drugs: Inotropic Agents01:26

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Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
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Updated: May 14, 2025

Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
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Structural Heart Interventions in Patients with Left Ventricular Assist Devices.

Puvi Seshiah1, Eugene Chung1, Santiago Garcia1

  • 1The Christ Hospital Heath Network, The Heart & Vascular Institute, Cincinnati, OH 45219, USA.

Reviews in Cardiovascular Medicine
|May 12, 2025
PubMed
Summary
This summary is machine-generated.

Left ventricular assist devices (LVADs) improve outcomes for advanced heart failure patients. This review details diagnosing and treating structural heart disease in LVAD patients using tailored transcatheter interventions.

Keywords:
left ventricular assist devicetranscatheter interventionsvalvular heart disease

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Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Interventional Cardiology

Background:

  • Left ventricular assist devices (LVADs) have significantly improved survival and quality of life for patients with advanced heart failure (HF).
  • Patients with LVADs often present with complex comorbidities and structural heart disease, necessitating specialized care.
  • The native heart's function is crucial for LVAD support, making its structural integrity vital.

Purpose of the Study:

  • To provide a comprehensive review of diagnosing and treating structural heart disease in patients with LVADs.
  • To emphasize the importance of multidisciplinary collaboration between HF cardiologists, surgeons, and interventionalists.
  • To highlight individualized transcatheter interventional strategies for LVAD-related complications.

Main Methods:

  • Review of current literature and clinical practices regarding structural heart disease in LVAD patients.
  • Discussion of diagnostic modalities for identifying LVAD circuit and native heart failures.
  • Analysis of transcatheter intervention techniques for specific structural lesions.

Main Results:

  • Multiple failure points exist in the LVAD circuit and native heart, including regurgitant valve lesions, interatrial shunts, and outflow cannula obstruction.
  • Transcatheter interventions offer tailored solutions for these complex structural heart issues.
  • Successful management requires a collaborative, individualized approach.

Conclusions:

  • Structural heart disease poses significant risks in LVAD patients, impacting morbidity and mortality.
  • Early diagnosis and prompt, tailored transcatheter interventions are key to improving outcomes.
  • Multidisciplinary collaboration is essential for optimizing care in this complex patient population.