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Left ventricular assist device therapy in advanced heart failure: patient selection and outcomes.

Publication ,  Journal Article
Gustafsson, F; Rogers, JG
Published in: Eur J Heart Fail
May 2017

Despite improvements in pharmacological therapy and pacing, prognosis in advanced heart failure (HF) remains poor, with a 1-year mortality of 25-50%. While heart transplantation provides excellent survival and quality of life for eligible patients, only a few can be offered this treatment due to shortage of donor organs. Implantable left ventricular assist device (LVAD) technology has improved considerably, and the currently used continuous flow devices may last >10 years in a patient. LVADs are being used increasingly both as bridge-to-transplantation and as destination therapy. Current studies report 1- and 2-year survival after LVAD implantation of 80% and 70%, respectively. Outcome after LVAD implantation in stable patients is superior to that of 'crash and burn' patients or patients sliding on inotropes, favouring early referral and implantation. This review summarizes factors to consider when deciding on LVAD implantation such as age, co-morbidity, and cardiac pathophysiology. Complications to LVAD therapy are reviewed. It is concluded that while complications with LVAD therapy are not uncommon, most are manageable, and current outcomes clearly justify use of LVADs in advanced HF.

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Published In

Eur J Heart Fail

DOI

EISSN

1879-0844

Publication Date

May 2017

Volume

19

Issue

5

Start / End Page

595 / 602

Location

England

Related Subject Headings

  • Treatment Outcome
  • Severity of Illness Index
  • Patient Selection
  • Humans
  • Heart-Assist Devices
  • Heart Failure
  • Echocardiography
  • Cardiovascular System & Hematology
  • 3201 Cardiovascular medicine and haematology
  • 1102 Cardiorespiratory Medicine and Haematology
 

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Gustafsson, F., & Rogers, J. G. (2017). Left ventricular assist device therapy in advanced heart failure: patient selection and outcomes. Eur J Heart Fail, 19(5), 595–602. https://doi.org/10.1002/ejhf.779
Gustafsson, Finn, and Joseph G. Rogers. “Left ventricular assist device therapy in advanced heart failure: patient selection and outcomes.Eur J Heart Fail 19, no. 5 (May 2017): 595–602. https://doi.org/10.1002/ejhf.779.
Gustafsson F, Rogers JG. Left ventricular assist device therapy in advanced heart failure: patient selection and outcomes. Eur J Heart Fail. 2017 May;19(5):595–602.
Gustafsson, Finn, and Joseph G. Rogers. “Left ventricular assist device therapy in advanced heart failure: patient selection and outcomes.Eur J Heart Fail, vol. 19, no. 5, May 2017, pp. 595–602. Pubmed, doi:10.1002/ejhf.779.
Gustafsson F, Rogers JG. Left ventricular assist device therapy in advanced heart failure: patient selection and outcomes. Eur J Heart Fail. 2017 May;19(5):595–602.
Journal cover image

Published In

Eur J Heart Fail

DOI

EISSN

1879-0844

Publication Date

May 2017

Volume

19

Issue

5

Start / End Page

595 / 602

Location

England

Related Subject Headings

  • Treatment Outcome
  • Severity of Illness Index
  • Patient Selection
  • Humans
  • Heart-Assist Devices
  • Heart Failure
  • Echocardiography
  • Cardiovascular System & Hematology
  • 3201 Cardiovascular medicine and haematology
  • 1102 Cardiorespiratory Medicine and Haematology