Durable Mechanical Circulatory Support in Advanced Heart Failure

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Durable Mechanical Circulatory Support in Advanced Heart Failure Anuradha Lala, MD, Mandeep R. Mehra, MD Cardiology Clinics Volume 31, Issue 4, Pages 581-593 (November 2013) DOI: 10.1016/j.ccl.2013.07.003 Copyright © 2013 Elsevier Inc. Terms and Conditions

Fig. 1 (A) HeartMate XVE (first generation, pulsatile-flow pump) and HeartMate II (second generation, continuous-flow pump). (B) HeartMate II left ventricular assist device. (C) HeartMate II external equipment. (Courtesy of Thoratec, Pleasanton, CA.) Cardiology Clinics 2013 31, 581-593DOI: (10.1016/j.ccl.2013.07.003) Copyright © 2013 Elsevier Inc. Terms and Conditions

Fig. 2 HeartWare device (third generation, centrifugal-flow pump). (Courtesy of HeartWare, Framingham, MA.) Cardiology Clinics 2013 31, 581-593DOI: (10.1016/j.ccl.2013.07.003) Copyright © 2013 Elsevier Inc. Terms and Conditions

Fig. 3 Sample Thoratec console display screen, showing Pump flow, Pump speed, Pulse index, and Pump power. Cardiology Clinics 2013 31, 581-593DOI: (10.1016/j.ccl.2013.07.003) Copyright © 2013 Elsevier Inc. Terms and Conditions

Fig. 4 Device selection flow chart. BTC, bridge to candidacy; BTT, bridge to transplantation; DT, destination therapy; MCS, mechanical circulatory support; OHTx, orthotopic heart transplant. Cardiology Clinics 2013 31, 581-593DOI: (10.1016/j.ccl.2013.07.003) Copyright © 2013 Elsevier Inc. Terms and Conditions

Fig. 5 Evaluation of hypotension in a patient with a left ventricular assist device. JVP, jugular venous pressure; LV, left ventricle; MAP, mean arterial pressure; PAC, pulmonary artery catheter; RV, right ventricle; WBC, white blood cells. Cardiology Clinics 2013 31, 581-593DOI: (10.1016/j.ccl.2013.07.003) Copyright © 2013 Elsevier Inc. Terms and Conditions

Fig. 6 Device alarms: causes and potential interventions. LV fcn, left ventricular function; VAD, ventricular assist device. Cardiology Clinics 2013 31, 581-593DOI: (10.1016/j.ccl.2013.07.003) Copyright © 2013 Elsevier Inc. Terms and Conditions

Fig. 7 Approach to emergency encounters in VAD patients. ACLS, Adult Cardiac Life Support; CPR, cardiopulmonary resuscitation; EKG, electrocardiogram; VT/VF, ventricular tachycardia/fibrillation. Cardiology Clinics 2013 31, 581-593DOI: (10.1016/j.ccl.2013.07.003) Copyright © 2013 Elsevier Inc. Terms and Conditions

Fig. 8 SynCardia total artificial heart. (Courtesy of syncardia.com.) Cardiology Clinics 2013 31, 581-593DOI: (10.1016/j.ccl.2013.07.003) Copyright © 2013 Elsevier Inc. Terms and Conditions