Perioperative management This chapter focuses on the early postoperative care of patients with ventricular assist devices (VADs). Appropriate patient selection and optimal implantation techniques greatly simplify postoperative management. Indeed, some…
Historical note The first left ventricular assist device (LVAD) was implanted in 1963 by Dr. DeBakey in a patient with postcardiotomy shock. As the incidence of heart failure rose to…
Introduction Heart failure (HF) is one of the major medical burdens in our society. Complete recovery of the heart after insult has been an attractive goal for many clinicians and…
Development of mechanical circulatory support systems The methods for providing mechanical circulatory support (MCS) have varied greatly. The evolution of MCS technology has been gradual, as the biological barriers to…
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…
