CBS 2019
CBSMD教育中心
中 文

Congestive Heart Failure

Abstract

Recommended Article

Dapagliflozin Effects on Biomarkers, Symptoms, and Functional Status in Patients With Heart Failure With Reduced Ejection Fraction: The DEFINE-HF Trial Association of Left Ventricular Systolic Function With Incident Heart Failure in Late Life Dilated cardiomyopathy: so many cardiomyopathies! Outcomes and Effect of Treatment According to Etiology in HFrEF An Analysis of PARADIGM-HF The Role of the Pericardium in Heart Failure: Implications for Pathophysiology and Treatment Age-Related Characteristics and Outcomes of Patients With Heart Failure With Preserved Ejection Fraction Mechanical circulatory support devices in advanced heart failure: 2020 and beyond Change in plasma volume and prognosis in acute decompensated heart failure: an observational cohort study

Review Article2020 Sep 21;S0033-0620(20)30158-4.

JOURNAL:Prog Cardiovasc Dis. Article Link

Mechanical circulatory support devices in advanced heart failure: 2020 and beyond

JL Vieira, HO Ventura, MR Mehra et al. Keywords: advanced heart failure; cardiogenic shock; hemocompatibility; INTERMACS; LVAD; left ventricular assist device; mechanical circulatory support

ABSTRACT

Substantial progress in the field of mechanical circulatory support (MCS) has expanded the treatment options for patients with advanced-stage heart failure (HF). Currently available MCS devices can be implanted percutaneously or surgically. They can also be configured to support the left, right, or both ventricles, offering varying levels of circulatory support. Short-term temporary MCS devices are primarily used in high-risk percutaneous coronary intervention, cardiogenic shock, and post-cardiac arrest, while durable left ventricular assist systems (LVAS) are increasingly utilized either as a bridge-to-transplant, bridge to decision, or as a destination therapy. The evolution from older pulsatile devices to continuous-flow LVAS and the incorporation of smaller pumps, with no valves, fewer moving parts, and improved hemocompatibility has translated into improved clinical outcomes, greater durability, fewer adverse events, and reduced overall cost of care. However, despite marked advances in device design and clinical management, determining MCS candidacy is often difficult and requires the integration of clinical, biomarker, imaging, exercise, and hemodynamic data. This review aims to provide a summary of the current use of short-term and durable MCS devices in the treatment of advanced-stage HF, highlighting several aspects of LVAS support and the challenges that remain.