title: Managing long-term complications of left ventricular assist device therapy.
abstract: OBJECTIVE
  As permanent support with ventricular assist devices (VADs) has become a reality and increasing numbers of patients are being supported for several years, the interactions between the VAD and the body and the management of complications during life-long support have gained the interest of clinicians and biomedical engineers.
  
  
  RESULTS
  Several interactions between the body and the implanted pump, including changes in the coagulation system, structure and function of the aortic valve, VAD-related infections, and technical failure as well as psychosocial aspects and their specific management have been described.
  
  
  CONCLUSIONS
  With enormous progress made in VAD technology, the incidence of complications has decreased over the years. However, with longer times of support, many aspects of the interaction between the implanted pump and the patient's body have been recognized. The management of these interactions and possible complications remain challenging, but it is possible to achieve long-term event-free VAD support.
authors: Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany. potapov@dhzb.de
authors: Evgenij V
authors: EV
authors: Potapov
authors: Alexander
authors: A
authors: Stepanenko
authors: Thomas
authors: T
authors: Krabatsch
authors: Roland
authors: R
authors: Hetzer
mesh_terms: D001021:Aortic Valve; D002404:Catheterization; D004868:Equipment Failure; D006333:Heart Failure / Q000473:pathology / Q000628:therapy*; D006352:Heart Ventricles / Q000473:pathology*; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary; D012307:Risk Factors; D013923:Thromboembolism; D013997:Time Factors; D018497:Ventricular Dysfunction, Right