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Left Ventricular Assist Devices: The What and the Who. Lance E. Sullenberger MD FACC FACP Capital Cardiology Associates. But Heart Failure Increasing…. US Heart Transplants Stable. Left Ventricular Assist Device Pulsatile Flow. Not a true artificial heart. - PowerPoint PPT Presentation
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Left Ventricular Assist Devices:The What and the Who
Lance E. Sullenberger MD FACC FACPCapital Cardiology Associates
US Heart Transplants StableBut Heart Failure Increasing…
Left Ventricular Assist DevicePulsatile Flow
• Not a true artificial heart.
• Assists the left ventricle in passing oxygenated blood through the body.
• Initially was a pulsatile device (similar to native heart…)
Left Ventricular Assist DeviceContinuous (Axial) Flow
Pulsatile Flow is OutAxial Flow is In
The Down Side• Infection• Bleeding• Thrombosis• Embolism• Battery issues• Hemolysis
Who Gets an LVAD?
• Bridge to Recovery
• Bridge to Transplant
• Destination Therapy
Bridge to Recovery
• Acute Myocarditis
• Acute Myocardial Infarction
• Peripartum Cardiomyopathy
• Younger• Previously healthy• Few comorbidities
Bridge to Transplant
Destination TherapyREMATCH Trial
• 129 patients• Ineligible for cardiac
transplant• Class IV CHF• ½ received LVAD• ½ received medical
therapy alone
• Can’t get a TX– Older– Hepatitis– DM with small vessel
disease• Might not get a TX– Renal issues– PHTN
• Complex surgical
Warning Signs!!
Inability to Take CHF Therapy
Low Sodium
Cardiorenal Syndrome
Warning Signs!• Recurrent Admissions• Low Blood Pressure• Hyponatremia• Poor Renal Function• Use of Continuous
Inotropes• Increasing diuretic
dose• Worsening Heart
Failure Class
Bring It Home….
LANCE SULLENBERGER [email protected]
Thank You!!!