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- Title
Ventricular assist devices for heart failure: a focus on patient selection and complications.
- Authors
Cipriani, Manlio; De Simone, Vincenzo; D'Angelo, Luciana; Perna, Enrico; Lilliu, Marzia; Bovolo, Virginia; Oliva, Fabrizio; Frigerio, Maria
- Abstract
Heart transplantation represents the "gold standard" for the treatment of patients with end-stage heart failure, but remains challenged by inadequate donor supply, finite graft survival, and long-term complications arising from immunosuppressive therapy. In addition, a lot of patients waiting for a heart transplant experience clinical deterioration, and other patients become ineligible to undergo this treatment due to their age or relevant comorbidities. Left ventricular assist devices have emerged as a valid therapeutic option for advanced heart failure. In recent years, we have seen significant advances not only in the technologies available, but also in patient selection, indications for use, and management after implantation. Consequently, there has been an increase in the number of implants and an improvement in the survival rate and quality of life for these patients. At the same time, there are new challenges on the horizon. Patient selection is a difficult process, based on clinical and imaging parameters and risk scores, and more data are needed to refine patient selection criteria and the timing of the implant. Left ventricular assist device-related complications are still a serious problem, causing adverse events and hospital readmissions. Continuous progress in the development of these implantable devices, such as a further reduction in size and hopefully the abolition of the external driveline, will probably make ventricular assist devices an option also for less advanced stages of heart failure. Here, we discuss the current indications for left ventricular assist device implantation, patient selection criteria, and the most frequent complications associated with these devices.
- Subjects
HEART assist devices; HEART failure treatment; PATIENT selection; HEART transplantation complications; ORGAN donors; ARTIFICIAL implants
- Publication
Research Reports in Clinical Cardiology, 2014, Vol 5, p199
- ISSN
1179-8475
- Publication type
Article
- DOI
10.2147/RRCC.S48886