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- Title
Left Ventricular Assist Device as a Destination Therapy: Current Situation and the Importance of Patient Selection.
- Authors
Melendo-Viu, María; Dobarro, David; Raposeiras Roubin, Sergio; Llamas Pernas, Carmen; Moliz Cordón, Candela; Vazquez Lamas, Miriam; Piñón Esteban, Miguel; Varela Martínez, Maria Ángela; Abu Assi, Emad; Pita Romero, Rafael; Legarra Calderón, Juan José; Íñiguez Romo, Andrés
- Abstract
Advanced heart failure is a growing problem for which the best treatment is cardiac transplantation. However, the shortage of donors' hearts made left ventricular assist devices as destination therapy (DT-LVAD) a highly recommended alternative: they improved mid-term prognosis as well as patients' quality of life. Current intracorporeal pumps with a centrifugal continuous flow evolved in the last few years. Since 2003, when first LVAD was approved for long-term support, smaller device sizes with better survival and hemocompatibility profile were reached. The most important difficulty lies in the moment of the implant. Recent indications range from INTERMACS class 2 to 4, with close monitoring in intermediate cases. Moreover, a large multiparametric study is needed for considering the candidacy: basal situation, with a special interest in frailty, comorbidities, including renal and hepatic dysfunction, and medical background, considering every prior cardiac condition, must be evaluated. In addition, some clinical risk scores can be helpful to measure the possibility of right heart failure or morbi-mortality. With this review, we sought to summarize all the device improvements, with their updated clinical results, as well as to focus on all the patient selection criteria.
- Subjects
HEART assist devices; PATIENT selection; DISEASE risk factors; CENTRIFUGAL pumps; HEART transplantation; DEEP brain stimulation; HEART failure
- Publication
Life (2075-1729), 2023, Vol 13, Issue 4, p1065
- ISSN
2075-1729
- Publication type
Article
- DOI
10.3390/life13041065