Left ventricular assist device management in patients chronically supported for advanced heart failure.
OBJECTIVE
This review summarizes management strategies to reduce morbidity and mortality in heart failure patients supported chronically with implantable left ventricular assist devices (LVADs).


RESULTS
As the population of patients supported with long-term LVADs has grown, patient selection, operative technique, and patient management strategies have been refined, leading to improved outcomes. This review summarizes recent findings on LVAD candidate selection, and discusses outpatient strategies to optimize device performance and heart failure management. It also reviews important device complications that warrant close outpatient monitoring.


CONCLUSIONS
Managing patients on chronic LVAD support requires regular patient follow-up, multidisciplinary care teams, and frequent laboratory and echocardiographic surveillance to ensure optimal outcomes.
Division of Cardiovascular Medicine, Section of Cardiac Surgery, University of Michigan Health System, Ann Arbor, MI 48109, USA.
Jennifer
J
Cowger
Matthew A
MA
Romano
John
J
Stulak
Francis D
FD
Pagani
Keith D
KD
Aaronson
D002908:Chronic Disease; D018450:Disease Progression; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000628:therapy*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000294:innervation / Q000473:pathology*; D006353:Heart-Assist Devices; D006801:Humans; D010045:Outpatients; D010353:Patient Education as Topic; D019990:Perioperative Care; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*