pubmed.ncbi.nlm.nih.gov

Ventricular assist devices: pharmacological aspects of a mechanical therapy - PubMed

Review

Ventricular assist devices: pharmacological aspects of a mechanical therapy

O Wever-Pinzon et al. Pharmacol Ther. 2012 May.

Abstract

Heart failure (HF) is a global epidemic that continues to cause significant morbidity and mortality despite advances in medical therapy. Ventricular assist device technology has emerged as a therapeutic option to bridge patients with end-stage HF to heart transplantation or as an alternative to transplantation in selected patients. In some patients, mechanical unloading induced by ventricular assist devices leads to improvement of myocardial function and a possibility of device removal. The implementation of this advanced technology requires multiple pharmacological interventions, both in the perioperative and long-term periods, in order to minimize potential complications and improve patient outcomes. We herein review the latest available evidence supporting the use of specific pharmacological interventions and current practices in the care of these patients: anticoagulation, bleeding management, pump thrombosis, infections, arrhythmias, right ventricular failure, hypertension, desensitization protocols, among others. Areas of uncertainty and ground for future research are also highlighted.

Copyright © 2012 Elsevier Inc. All rights reserved.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1

Factors affecting the risk balance between thrombosis and bleeding in LVAD supported patients.

Similar articles

Cited by

References

    1. Ambardekar AV, Allen LA, Lindenfeld J, Lowery CM, Cannon AP, Cleveland JC, Jr, Brieke A, Sauer WH. Implantable cardioverter-defibrillator shocks in patients with a left ventricular assist device. J Heart Lung Transplant. 2010;29:771–776. - PubMed
    1. Amir O, Bracey AW, Smart FW, Delgado RM, III, Shah N, Kar B. A successful anticoagulation protocol for the first HeartMate II implantation in the United States. Tex Heart Inst J. 2005;32:399–401. - PMC - PubMed
    1. Anastasiadis K, Antonitsis P, Argiriadou H, Koliakos G, Doumas A, Khayat A, Papakonstantinou C, Westaby S. Hybrid approach of ventricular assist device and autologous bone marrow stem cells implantation in end-stage ischemic heart failure enhances myocardial reperfusion. J Transl Med. 2011;9:12. - PMC - PubMed
    1. Andersen M, Videbaek R, Boesgaard S, Sander K, Hansen PB, Gustafsson F. Incidence of ventricular arrhythmias in patients on long-term support with a continuous-flow assist device (HeartMate II) J Heart Lung Transplant. 2009;28:733–735. - PubMed
    1. Anker SD, Coats AJ. Cardiac cachexia: a syndrome with impaired survival and immune and neuroendocrine activation. Chest. 1999;115:836–847. - PubMed

Publication types

MeSH terms