Limits...
Treatment options in end-stage heart failure: where to go from here?

Haeck ML, Hoogslag GE, Rodrigo SF, Atsma DE, Klautz RJ, van der Wall EE, Schalij MJ, Verwey HF - Neth Heart J (2012)

Bottom Line: Chronic heart failure is a major healthcare problem associated with high morbidity and mortality.The golden standard treatment for heart failure is heart transplantation after failure of medical therapy, surgery and/or cardiac resynchronisation therapy.In order to improve patients' outcome and quality of life, new emerging treatment modalities are currently being investigated, including mechanical cardiac support devices, of which the left ventricular assist device is the most promising treatment option.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands.

ABSTRACT
Chronic heart failure is a major healthcare problem associated with high morbidity and mortality. Despite significant progress in treatment strategies, the prognosis of heart failure patients remains poor. The golden standard treatment for heart failure is heart transplantation after failure of medical therapy, surgery and/or cardiac resynchronisation therapy. In order to improve patients' outcome and quality of life, new emerging treatment modalities are currently being investigated, including mechanical cardiac support devices, of which the left ventricular assist device is the most promising treatment option. Structured care for heart failure patients according to the most recent international heart failure guidelines may further contribute to optimal decision-making. This article will review the conventional and novel treatment modalities of heart failure.

No MeSH data available.


Related in: MedlinePlus

Panel A shows a first-generation pulsatile flow left ventricular assist device (LVAD). Panel B shows a second-generation continuous flow LVAD. Both mechanical pumps are placed in the abdominal wall. The inflow cannula is placed in the apex of the left ventricle. The outflow cannula is anastamosed with the ascending aorta. A percutaneous lead connects the LVAD pump with an external system controller and the battery pack (Reprinted with permission of Slaughter et al.) [30]
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3303031&req=5

Fig2: Panel A shows a first-generation pulsatile flow left ventricular assist device (LVAD). Panel B shows a second-generation continuous flow LVAD. Both mechanical pumps are placed in the abdominal wall. The inflow cannula is placed in the apex of the left ventricle. The outflow cannula is anastamosed with the ascending aorta. A percutaneous lead connects the LVAD pump with an external system controller and the battery pack (Reprinted with permission of Slaughter et al.) [30]

Mentions: The second-generation assist devices consist of smaller axial continuous flow pumps (Fig. 2). Therefore, they require less extensive surgery reducing the risk of perioperative complications. Because these devices contain only one moving part they are more durable than pulsatile devices and noiseless [27, 30]. During development of the continuous flow pump, there was concern that continuous flow and therefore continuous end-organ perfusion could not be tolerated by the body. This has been contradicted by demonstrating superior survival and less organ failure in patients with continuous flow VADs compared with patients with pulsatile VADs [30].Fig. 2


Treatment options in end-stage heart failure: where to go from here?

Haeck ML, Hoogslag GE, Rodrigo SF, Atsma DE, Klautz RJ, van der Wall EE, Schalij MJ, Verwey HF - Neth Heart J (2012)

Panel A shows a first-generation pulsatile flow left ventricular assist device (LVAD). Panel B shows a second-generation continuous flow LVAD. Both mechanical pumps are placed in the abdominal wall. The inflow cannula is placed in the apex of the left ventricle. The outflow cannula is anastamosed with the ascending aorta. A percutaneous lead connects the LVAD pump with an external system controller and the battery pack (Reprinted with permission of Slaughter et al.) [30]
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3303031&req=5

Fig2: Panel A shows a first-generation pulsatile flow left ventricular assist device (LVAD). Panel B shows a second-generation continuous flow LVAD. Both mechanical pumps are placed in the abdominal wall. The inflow cannula is placed in the apex of the left ventricle. The outflow cannula is anastamosed with the ascending aorta. A percutaneous lead connects the LVAD pump with an external system controller and the battery pack (Reprinted with permission of Slaughter et al.) [30]
Mentions: The second-generation assist devices consist of smaller axial continuous flow pumps (Fig. 2). Therefore, they require less extensive surgery reducing the risk of perioperative complications. Because these devices contain only one moving part they are more durable than pulsatile devices and noiseless [27, 30]. During development of the continuous flow pump, there was concern that continuous flow and therefore continuous end-organ perfusion could not be tolerated by the body. This has been contradicted by demonstrating superior survival and less organ failure in patients with continuous flow VADs compared with patients with pulsatile VADs [30].Fig. 2

Bottom Line: Chronic heart failure is a major healthcare problem associated with high morbidity and mortality.The golden standard treatment for heart failure is heart transplantation after failure of medical therapy, surgery and/or cardiac resynchronisation therapy.In order to improve patients' outcome and quality of life, new emerging treatment modalities are currently being investigated, including mechanical cardiac support devices, of which the left ventricular assist device is the most promising treatment option.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands.

ABSTRACT
Chronic heart failure is a major healthcare problem associated with high morbidity and mortality. Despite significant progress in treatment strategies, the prognosis of heart failure patients remains poor. The golden standard treatment for heart failure is heart transplantation after failure of medical therapy, surgery and/or cardiac resynchronisation therapy. In order to improve patients' outcome and quality of life, new emerging treatment modalities are currently being investigated, including mechanical cardiac support devices, of which the left ventricular assist device is the most promising treatment option. Structured care for heart failure patients according to the most recent international heart failure guidelines may further contribute to optimal decision-making. This article will review the conventional and novel treatment modalities of heart failure.

No MeSH data available.


Related in: MedlinePlus