Clinical implications of hemodynamic assessment during left ventricular assist device therapy

J Cardiol. 2018 Apr;71(4):352-358. doi: 10.1016/j.jjcc.2017.12.001. Epub 2017 Dec 26.

Abstract

Left ventricular assist devices (LVADs) significantly improve outcomes of advanced heart failure patients. However, patients continue to have high readmission rates due to complications ranging from bleeding, thrombosis, heart failure, and infection. Considering that the hallmark benefit of LVAD therapy is improvement in hemodynamics (cardiac unloading and increased cardiac output), hemodynamic assessment on LVAD support is key to better understand these difficult complications and may serve as a tool to resolving them. In this review, we will discuss the hemodynamic changes following LVAD implantation, and the implications and prognostic impact of hemodynamic optimization on outcomes and complications.

Keywords: Heart failure; HeartMate; Left ventricular assist device; Ramp.

Publication types

  • Review

MeSH terms

  • Aged
  • Female
  • Heart Failure / physiopathology
  • Heart Failure / surgery*
  • Heart Ventricles / physiopathology
  • Heart Ventricles / surgery
  • Heart-Assist Devices / adverse effects*
  • Hemodynamics / physiology*
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / etiology
  • Postoperative Complications / physiopathology*
  • Postoperative Period
  • Prognosis
  • Prosthesis Implantation / adverse effects*
  • Treatment Outcome