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Review
. 2011 Mar;34(3):147-52.
doi: 10.1002/clc.20825. Epub 2011 Feb 9.

Implantable mechanical circulatory support: demystifying patients with ventricular assist devices and artificial hearts

Keyur B Shah  1 , Daniel G Tang, Richard H Cooke, Suzanne Harton, Maureen Flattery, Gundars J Katlaps, Vigneshwar Kasirajan, Michael L Hess
Affiliations
Review

Implantable mechanical circulatory support: demystifying patients with ventricular assist devices and artificial hearts

Keyur B Shah et al. Clin Cardiol. 2011 Mar.

Abstract

Engineering advancements have expanded the role for mechanical circulatory support devices in the patient with heart failure. More patients with mechanical circulatory support are being discharged from the implanting institution and will be seen by clinicians outside the immediate surgical or heart-failure team. This review provides a practical understanding of device design and physiology, general troubleshooting, and limitations and complications for implantable left ventricular assist devices (pulsatile-flow and continuous-flow pumps) and the total artificial heart.

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Figures

Figure 1
Figure 1
Topogram (A) of the HeartMate XVE LVAD. The device is implanted in a preperitoneal or intra‐abdominal pocket. Graphic depiction (B) of the implanted device (reprinted with permission from Thoratec Corporation). Abbreviations: D, driveline; I, inflow cannula; LVAD, left ventricular assist device; O, outflow cannula; P, displacement pump.
Figure 2
Figure 2
Topogram (A) of the HeartMate II LVAD. The device is implanted in a preperitoneal pocket. Graphic depiction (B) of the implanted device (reprinted with permission from Thoratec Corporation). Abbreviations: D, driveline; I, inflow cannula; LVAD, left ventricular assist device; O, outflow cannula; P, impeller pump.
Figure 3
Figure 3
Potential causes of (A) suction events and (B) inadequate left ventricular unloading with a continuous‐flow LVAD. Abbreviations: AV, atrioventricular; CVP, central venous pressure; LV, left ventricular; LVAD, left ventricular assist device; OR, operating room; RV, right ventricular; RVAD, right ventricular assist device.
Figure 4
Figure 4
Topogram (A) of the CardioWest total artificial heart. The device replaces the native ventricles and cardiac valves. Four tilting disk valves are located in the tricuspid, mitral, pulmonic, and aortic positions. Graphic depiction (B) of the implanted device (courtesy of SynCardia Systems). Abbreviations: A, aortic; D, driveline; M, mitral; P, pulmonic; T, tricuspid.
Figure 5
Figure 5
Intraoperative photograph of total artificial heart implantation. The total artificial heart seen in situ, prior to chest closure.
See this image and copyright information in PMC

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