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Mechanical Circulatory Support: A Companion to Braunwald's Heart Disease

Joined: November 1, 2023
Articles: 22

Cardiovascular

Postoperative VAD Management: Operating Room to Discharge and Beyond: Surgical and Medical Considerations

Perioperative management This chapter focuses on the early postoperative care of patients with ventricular assist devices (VADs). Appropriate patient selection and optimal implantation techniques greatly simplify postoperative management. Indeed, some problems created by suboptimal implantation techniques are difficult or impossible…

September 15, 2023

Cardiovascular

Operative Techniques and Intraoperative Management

Historical note The first left ventricular assist device (LVAD) was implanted in 1963 by Dr. DeBakey in a patient with postcardiotomy shock. As the incidence of heart failure rose to epidemic proportions, the LVAD emerged as a new solution to…

September 15, 2023

Cardiovascular

Current Types of Devices for Durable Mechanical Circulatory Support

Development of mechanical circulatory support systems The methods for providing mechanical circulatory support (MCS) have varied greatly. The evolution of MCS technology has been gradual, as the biological barriers to progress have remained constant and difficult. Clinicians and engineers have…

September 15, 2023

Cardiovascular

The Biological Response to Ventricular Unloading

Introduction Heart failure (HF) is one of the major medical burdens in our society. Complete recovery of the heart after insult has been an attractive goal for many clinicians and scientists for long time. Mechanical circulatory support (MCS) devices, such…

September 15, 2023

Cardiovascular

Hemocompatibility in Mechanical Circulatory Support

Introduction Understanding the hemocompatibility of mechanical circulatory support (MCS) devices requires insight into two scientific disciplines: biology and physics Biology related to MCS is only partially understood and at times seems unpredictable. Mother Nature is responsible for unleashing a variety…

September 15, 2023

Cardiovascular

Understanding the Principles of Continuous-Flow Rotary Left Ventricular Assist Devices

Introduction Mechanical circulatory support with durable left ventricular assist devices (LVADs) has become a mainstay therapy for treatment of advanced heart failure refractory to optimal medical management and has now surpassed cardiac transplantation as the most frequently utilized surgical therapy…

September 15, 2023

Cardiovascular

The Role of Extracorporeal Membrane Oxygenation in Cardiac Support

Background The modern era of extracorporeal circulation began in the early 1950s, with cardiopulmonary bypass (CPB) used to support patients during open-heart operations for the repair of congenital heart defects. Over the course of the next two decades, improvements to…

September 15, 2023

Cardiovascular

Acute Circulatory Support

Introduction Cardiogenic shock (CS) is a state of insufficient cardiac output and end-organ perfusion that can be the terminal phase of many different cardiac conditions, including acute coronary syndromes, arrhythmias, progression of chronic cardiomyopathy, and acute cardiac dysfunction in the…

September 15, 2023

Cardiovascular

Candidate Selection and Decision Making in Mechanical Circulatory Support

Introduction Deciding who should and who should not proceed with mechanical circulatory support (MCS)—including timing and device type—is one of the most difficult challenges in medicine. While there are now over 6 million people in the United States with heart…

September 15, 2023

Cardiovascular

Risk Stratification in Advanced Heart Failure

Introduction Risk factors or markers for mortality in heart failure (HF) include a long list of clinical parameters, including history, physical examination, laboratory values, hemodynamics, cardiac structure and function, and biomarkers ( Table 3.1 ). This chapter reviews predictors of…

September 15, 2023