Systemic consequences of ventricular assist devices: alterations of coagulation, immune function, inflammation, and the neuroendocrine system.
Implantable ventricular assist devices have proven efficacious as a bridge to transplantation and as a bridge to recovery. Although current indications for use of assist devices are somewhat limited, they are likely to expand in the upcoming years, including their use as destination therapy for end-stage heart failure. Recipients of assist devices, however, are prone to certain device-specific complications, including excessive postoperative bleeding, late propensity for thromboembolism, infections, and systemic inflammation, which may contribute to end-organ dysfunction. This article reviews the systemic biochemical alterations underlying these clinical phenomena. As assist devices are increasingly used, better understanding of these systemic perturbations is imperative.
Hampton
Craig R
CR
The Division of Cardiothoracic Surgery, Department of Surgery, The University of Washington, Seattle 98195-6310, USA.
Verrier
Edward D
ED
D001778:Blood Coagulation Disorders / Q000209:etiology* / Q000276:immunology / Q000503:physiopathology; D004700:Endocrine System Diseases / Q000209:etiology* / Q000276:immunology / Q000503:physiopathology; D006333:Heart Failure / Q000276:immunology* / Q000503:physiopathology / Q000628:therapy*; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D007154:Immune System Diseases / Q000209:etiology* / Q000276:immunology / Q000503:physiopathology; D007249:Inflammation / Q000209:etiology* / Q000276:immunology / Q000503:physiopathology