Left Ventricular Assist Devices The What and the

Left Ventricular Assist Devices: The What and the Who Lance E. Sullenberger MD FACC FACP Capital Cardiology Associates

But US Heart Failure Transplants Increasing… Stable

Left Ventricular Assist Device Pulsatile Flow • Not a true artificial heart. • Assists the left ventricle in passing oxygenated blood through the body. • Initially was a pulsatile device (similar to native heart…)

Left Ventricular Assist Device Continuous (Axial) Flow

Pulsatile Flow is Out Axial Flow is In

The Down Side • • • Infection Bleeding Thrombosis Embolism Battery issues Hemolysis

Who Gets an LVAD? • Bridge to Recovery • Bridge to Transplant • Destination Therapy

Bridge to Recovery • Acute Myocarditis • Acute Myocardial Infarction • Peripartum Cardiomyopathy • Younger • Previously healthy • Few comorbidities

Bridge to Transplant

Destination Therapy REMATCH Trial • • Can’t a TX 129 get patients – Older • Ineligible for cardiac – Hepatitis transplant – DM with small vessel • Class IV CHF disease ½ received • • Might not get. LVAD a TX issues medical • –½Renal received –therapy PHTN alone • Complex surgical

Warning Signs!!

Inability to Take CHF Therapy

Low Sodium

Cardiorenal Syndrome

Warning Signs! Recurrent Admissions Low Blood Pressure Hyponatremia Poor Renal Function Use of Continuous Inotropes • Increasing diuretic dose • Worsening Heart Failure Class • • •

Bring It Home….

Thank You!!! LANCE SULLENBERGER MD LSULLENBERGER@CAPITALCARDIOLOGY. COM