Document Detail


Long-term continuous flow left ventricular assist device support and end-organ function: prospects for destination therapy.
MedLine Citation:
PMID:  20642766     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Pulsatile flow left ventricular assist devices (PF-LVADs) have successfully supported patients with severe heart failure for bridge-to-transplant (BTT) and destination therapy (DT). End-organ dysfunction is often reversed, optimizing the patient's condition to enhance survival, and quality of life. Questions have been raised regarding the potential for continuous flow LVADs (CF-LVADs) to provide the same quality of circulatory support. Prior research showing that PF is superior to continuous, non-PF does not appear to be relevant with CF-LVADs for BTT and DT. Under most clinical conditions, arterial pulsatility is present during CF-LVAD support, and this type of support should not be termed "nonpulsatile." Clinical studies have shown that renal, hepatic, and neurocognitive function is either maintained within a normal range, or is significantly improved, during CF-LVAD support for durations up to 15 months. Results of the randomized clinical trial between the CF HeartMate II and the pulsatile HeartMate XVE (both by Thoratec Corp, Pleasanton, CA, USA) are pending final US Food and Drug Administration (FDA) review and are not yet published. Studies of microcirculation during CF-LVAD support indicate that capillary blood flow is adequate to support cellular function. There are anecdotal cases of patients being supported with a CF-LVAD for over seven years with preserved end-organ function. Presently, there are no clinical reports indicating that end-organ function is not well maintained. Current clinical evidence indicates that end-organ perfusion and function can be well maintained for extended durations of support with a CF-LVAD.
Authors:
Mark S Slaughter
Related Documents :
8561626 - Cleveland clinic rotodynamic pump.
16090816 - Dynamic and stagnating plasma flow leading to magnetic-flux-tube collimation.
2252746 - Physiologic reactions of awake animals to an immediate switch from a pulsatile to nonpu...
9360136 - Long-term animal experiments with an intraventricular axial flow blood pump.
19127286 - Atmospheric hypoxia limits selection for large body size in insects.
2098266 - Functional, biochemical, and histopathological evidence of airway obstruction in rats f...
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  25     ISSN:  1540-8191     ISO Abbreviation:  J Card Surg     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  490-4     Citation Subset:  IM    
Affiliation:
Division of Thoracic and Cardiovascular Surgery, University of Louisville, Louisville, Kentucky 40202, USA. mark.slaughter@louisville.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Transcutaneous energy transmission for mechanical circulatory support systems: history, current stat...
Next Document:  A phylogenetic approach to disentangling the role of competition and habitat filtering in community ...