Clinically available intracorporeal left ventricular assist devices.
There are now 3 commercially approved intracorporeal left ventricular assist devices (LVADs). Product similarities include (1) LV apex, to pump, to ascending aorta flow patterns, (2) excellent hemodynamic support with reversal of heart failure and neurohormone/cytokine milieu, and (3) the requirement of major surgery for device implantation and later explantation, with or without transplant. Two electrically powered models allow a tether-free existence and hospital discharge. All complications are being addressed, and in the past decade, device failure and thromboemboli have been reduced. Infection continues to be an obstacle to more widespread adoption of therapy. Despite pre-LVAD shock, most patients (65% to 78% by Food and Drug Administration data) survive until transplant (averaging 80 to 96 days of LVAD support), and posttransplant survival is equal to nonbridged patients. As the problem of infection is reduced, more widespread LVAD use can be anticipated.
Kaufman Center for Heart Failure, Department of Thoracic & Cardiovascular Surgery, The Cleveland Clinic Foundation, OH, USA. mccartp@ccf.org
P M
PM
McCarthy
K
K
Hoercher
D018795:Device Approval / Q000331:legislation & jurisprudence; D004867:Equipment Design; D004868:Equipment Failure; D004869:Equipment Safety; D006331:Heart Diseases / Q000503:physiopathology / Q000601:surgery*; D006353:Heart-Assist Devices; D006801:Humans; D014481:United States; D014486:United States Food and Drug Administration; D016276:Ventricular Function / Q000502:physiology