title: Physiologic benefits of pulsatile perfusion during mechanical circulatory support for the treatment of acute and chronic heart failure in adults.
abstract: A growing population experiencing heart failure (100,000 patients/year), combined with a shortage of donor organs (less than 2200 hearts/year), has led to increased and expanded use of mechanical circulatory support (MCS) devices. MCS devices have successfully improved clinical outcomes, which are comparable with heart transplantation and result in better 1-year survival than optimal medical management therapies. The quality of perfusion provided during MCS therapy may play an important role in patient outcomes. Despite demonstrated physiologic benefits of pulsatile perfusion, continued use or development of pulsatile MCS devices has been widely abandoned in favor of continuous flow pumps owing to the large size and adverse risks events in the former class, which pose issues of thrombogenic surfaces, percutaneous lead infection, and durability. Next-generation MCS device development should ideally implement designs that offer the benefits of rotary pump technology while providing the physiologic benefits of pulsatile end-organ perfusion.
authors.affiliation: Department of Pediatrics, Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, Penn State Children's Hospital, Hershey, PA 17033-0850, USA.
authors.forename: Yulong
authors.initials: Y
authors.lastname: Guan
authors.forename: Tushar
authors.initials: T
authors.lastname: Karkhanis
authors.forename: Shigang
authors.initials: S
authors.lastname: Wang
authors.forename: Alan
authors.initials: A
authors.lastname: Rider
authors.forename: Steven C
authors.initials: SC
authors.lastname: Koenig
authors.forename: Mark S
authors.initials: MS
authors.lastname: Slaughter
authors.forename: Aly
authors.initials: A
authors.lastname: El Banayosy
authors.forename: Akif
authors.initials: A
authors.lastname: Undar
mesh_terms: D000328:Adult; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods; D006333:Heart Failure / Q000601:surgery / Q000628:therapy*; D006354:Heart, Artificial; D006353:Heart-Assist Devices; D006801:Humans; D011673:Pulsatile Flow