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Emerging ventricular assist devices for long-term cardiac support

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DonShimoda   Monday, 06/07/10 09:35:58 PM
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Emerging ventricular assist devices for long-term cardiac support

Nature Reviews Cardiology (February 2010)
Rajan Krishnamani, David DeNofrio & Marvin A. Konstam

The evolution of mechanical cardiac support has been fueled by an increasing need to support patients with end-stage heart failure. More than 100,000 patients are estimated to have severe, refractory (AHA/ACC stage D) heart failure. The prognosis in this group of patients is dismal, with a 4-year mortality of more than 50%. Of patients admitted to hospital with acute heart failure, the 1-year mortality is 30–50%. The option of cardiac transplantation is limited by organ availability and, as wait times have increased, the need for mechanical cardiac support as a bridge-to-transplant has also increased.

Innovations in ventricular assist device (VAD) technology has provided an alternative therapeutic option for patients with advanced heart failure. Initiated as a mechanical option to 'bridge' critically ill patients awaiting transplantation, VADs are being increasingly deployed as 'destination' devices to provide long-term support. With technical advances resulting in improved mechanical reliability, reduced postoperative morbidity and greater likelihood of patient acceptance, there is interest in expanding the applicability for destination VAD treatment beyond the current indication of severely ill patients who are not candidates for transplant. This Review examines the newer, third-generation VADs for mechanical cardiac support.

http://www.nature.com/nrcardio/journal/v7/n2/full/nrcardio.2009.222.html

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