Cardiac Emergencies in Patients with Left Ventricular Assist Devices

Jay D Pal; Joseph Cleveland; Brett T Reece; Jessica Byrd; Christopher N Pierce; Andreas Brieke; William K Cornwell 3rd

doi:10.1016/j.hfc.2020.02.003

Cardiac Emergencies in Patients with Left Ventricular Assist Devices

Heart Fail Clin. 2020 Jul;16(3):295-303. doi: 10.1016/j.hfc.2020.02.003.

Authors

Jay D Pal¹, Joseph Cleveland¹, Brett T Reece¹, Jessica Byrd¹, Christopher N Pierce¹, Andreas Brieke¹, William K Cornwell 3rd²

Affiliations

¹ Department of Medicine-Cardiology, University of Colorado Anschutz Medical Campus, 12631 East 17th Avenue, B130, Office 7107, Aurora, CO 80045, USA.
² Department of Medicine-Cardiology, University of Colorado Anschutz Medical Campus, 12631 East 17th Avenue, B130, Office 7107, Aurora, CO 80045, USA. Electronic address: william.cornwell@cuanschutz.edu.

PMID: 32503753
DOI: 10.1016/j.hfc.2020.02.003

Abstract

Continuous-flow left ventricular assist devices are frequently used for management of patients with advanced heart failure with reduced ejection fraction. Although technologic advancements have contributed to improved outcomes, several complications arise over time. These complications result from several factors, including medication effects, physiologic responses to chronic exposure to circulatory support that is minimally/entirely nonpulsatile, and dysfunction of the device itself. Clinical presentation can range from chronic and indolent to acute, life-threatening emergencies. Several areas of uncertainty exist regarding best practices for managing complications; however, growing awareness has led to development of new guidelines to reduce risk and improve outcomes.

Keywords: Blood pressure; Cardiogenic shock; Continuous-flow left ventricular assist device.

Publication types

Review

MeSH terms

Emergency Treatment / methods*
Heart Failure* / etiology
Heart Failure* / physiopathology
Heart Failure* / therapy
Heart-Assist Devices*
Humans
Shock, Cardiogenic* / etiology
Shock, Cardiogenic* / therapy
Ventricular Dysfunction, Left / physiopathology
Ventricular Dysfunction, Left / therapy