Introduction Mechanical circulatory support with durable left ventricular assist devices (LVADs) has become a mainstay therapy for treatment of advanced heart failure refractory to optimal medical management and has now…
Background The modern era of extracorporeal circulation began in the early 1950s, with cardiopulmonary bypass (CPB) used to support patients during open-heart operations for the repair of congenital heart defects….
Introduction Understanding the hemocompatibility of mechanical circulatory support (MCS) devices requires insight into two scientific disciplines: biology and physics/engineering. Biology related to MCS is only partially understood and at times…
Introduction Risk factors or markers for mortality in heart failure (HF) include a long list of clinical parameters, including history, physical examination, laboratory values, hemodynamics, cardiac structure and function, and…
Introduction Cardiogenic shock (CS) is a state of insufficient cardiac output and end-organ perfusion that can be the terminal phase of many different cardiac conditions, including acute coronary syndromes, arrhythmias,…
Introduction Deciding who should and who should not proceed with mechanical circulatory support (MCS)—including timing and device type—is one of the most difficult challenges in medicine. While there are now…
Introduction The term shock first appeared in the English medical literature in a translation by John Clarke of a French treatise on gunshot wounds by Henry LeDran in 1740, Traité…
Early mechanical circulatory support devices and technology development Establishing the Concept In the 1930s, Carrel and Lindbergh developed an in vitro artificial heart-like apparatus for keeping organs alive outside the…
Key Points 1. Cardiac patients and those who have had previous cardiac surgery often present for intrathoracic diagnostic or therapeutic noncardiac procedures. 2. Patients with coronary artery disease, valvular heart…
Key Points 1. The costs of healthcare are escalating. Goal-directed fluid therapy (GDT) and multimodal pain relief are ways to control cost while improving quality. 2. GDT is an integral…
