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Drug-coated balloons for small coronary artery disease (BASKET-SMALL 2): an open-label randomised non-inferiority trial Effect of Aspirin on All-Cause Mortality in the Healthy Elderly Geometry as a Confounder When Assessing Ventricular Systolic Function: Comparison Between Ejection Fraction and Strain Development and validation of a simple risk score to predict 30-day readmission after percutaneous coronary intervention in a cohort of medicare patients Genetic dysregulation of endothelin-1 is implicated in coronary microvascular dysfunction Coronary Angiography after Cardiac Arrest without ST-Segment Elevation A VOYAGER Meta-Analysis of the Impact of Statin Therapy on Low-Density Lipoprotein Cholesterol and Triglyceride Levels in Patients With Hypertriglyceridemia Cardiopulmonary Exercise Testing: What Is its Value? Novel functions of macrophages in the heart: insights into electrical conduction, stress, and diastolic dysfunction A Test in Context: E/A and E/e' to Assess Diastolic Dysfunction and LV Filling Pressure

Review Article2017 Jun 13;69(23):2845-2861. ​

JOURNAL:J Am Coll Cardiol. Article Link

Left Ventricular Assist Devices for Lifelong Support

Pinney SP, Anyanwu AC, Lala A et al. Keywords: cardiothoracic surgery; heart failure; hemocompatibility

ABSTRACT


Continuous-flow left ventricular assist devices (LVADs) have revolutionized advanced heart failure care. These compact, fully implantable heart pumps are capable of providing meaningful increases in survival, functional capacity, and quality of life. Implantation volumes continue to grow, but several challenges remain to be overcome before LVADs will be considered as the therapy of choice for all patients with advanced heart failure. They must be able to consistently extend survival for the long term (7 to 10 years), rather than the midterm (3 to 5 years) more typical of contemporary devices; they must incorporate design elements that reduce shear stress and avoid stasis to reduce the frequent adverse events of bleeding, stroke, and pump thrombosis; and they must become more cost-effective. The advancements in engineering, implantation technique, and medical management detailed in this review will highlight the progress made toward achieving lifelong LVAD support and the challenges that remain.