title: [What cardiologists should know to manage acute complications in mechanical circulatory support recipients].
abstract: Patients with advanced heart failure refractory to optimal medical treatment have a high mortality and a poor quality of life with frequent hospital admissions. The lack of alternative treatment options has prompted the development of mechanical circulatory support (MCS) devices, first as bridge to heart transplant and subsequently as destination therapy as a valid alternative to transplant. Last generation MCS devices are mechanically reliable and their management has become increasingly less complex. Nowadays, medium-term survival does not significantly differ between MCS and heart transplant recipients. MCS management programs require a multidisciplinary team to optimize the pathway leading to rehabilitation and improved quality of life and decrease the frequent occurrence of complications. However, in the near future with the growing number of implants, the chances for clinical cardiologists to come across a MCS recipient will increase. The management of general or acute problems will no longer be limited to tertiary implanting centers. A key issue to improve patient outcomes is the provision of a smooth and careful transition from the hospital environment to home care. The aim of this review is to start this process by providing basic notions and general indications through several scenarios of MCS recipients presenting to the emergency room for acute clinical problems.
authors.forename: Marco
authors.initials: M
authors.lastname: Marini
authors.forename: Claudia
authors.initials: C
authors.lastname: Raineri
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Tano
authors.forename: Manlio
authors.initials: M
authors.lastname: Cipriani
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Oliva
authors.forename: Renata
authors.initials: R
authors.lastname: De Maria
mesh_terms: D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000188:drug therapy / Q000209:etiology; D001803:Blood Transfusion; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy; D006333:Heart Failure / Q000401:mortality / Q000451:nursing / Q000601:surgery / Q000628:therapy; D016027:Heart Transplantation; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006470:Hemorrhage / Q000139:chemically induced / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000209:etiology; D013927:Thrombosis / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control
chemical_list: D000889:Anti-Arrhythmia Agents; D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors