title: Ventricular assist devices: pharmacological aspects of a mechanical therapy.
abstract: Heart failure (HF) is a global epidemic that continues to cause significant morbidity and mortality despite advances in medical therapy. Ventricular assist device technology has emerged as a therapeutic option to bridge patients with end-stage HF to heart transplantation or as an alternative to transplantation in selected patients. In some patients, mechanical unloading induced by ventricular assist devices leads to improvement of myocardial function and a possibility of device removal. The implementation of this advanced technology requires multiple pharmacological interventions, both in the perioperative and long-term periods, in order to minimize potential complications and improve patient outcomes. We herein review the latest available evidence supporting the use of specific pharmacological interventions and current practices in the care of these patients: anticoagulation, bleeding management, pump thrombosis, infections, arrhythmias, right ventricular failure, hypertension, desensitization protocols, among others. Areas of uncertainty and ground for future research are also highlighted.
authors.affiliation: Divisions of Cardiology & Molecular Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.
authors.forename: O
authors.initials: O
authors.lastname: Wever-Pinzon
authors.forename: J
authors.initials: J
authors.lastname: Stehlik
authors.forename: A G
authors.initials: AG
authors.lastname: Kfoury
authors.forename: J V
authors.initials: JV
authors.lastname: Terrovitis
authors.forename: N A
authors.initials: NA
authors.lastname: Diakos
authors.forename: C
authors.initials: C
authors.lastname: Charitos
authors.forename: D Y
authors.initials: DY
authors.lastname: Li
authors.forename: S G
authors.initials: SG
authors.lastname: Drakos
mesh_terms: D000818:Animals; D006333:Heart Failure / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D016027:Heart Transplantation / Q000379:methods; D006352:Heart Ventricles / Q000503:physiopathology / Q000601:surgery; D006353:Heart-Assist Devices; D006801:Humans; D019736:Prostheses and Implants