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Review
. 2018 Apr;71(4):352-358.
doi: 10.1016/j.jjcc.2017.12.001. Epub 2017 Dec 26.

Clinical implications of hemodynamic assessment during left ventricular assist device therapy

Teruhiko Imamura  1 , Ben Chung  1 , Ann Nguyen  1 , Gabriel Sayer  1 , Nir Uriel  2
Affiliations
Review

Clinical implications of hemodynamic assessment during left ventricular assist device therapy

Teruhiko Imamura et al. J Cardiol. 2018 Apr.

Abstract

Left ventricular assist devices (LVADs) significantly improve outcomes of advanced heart failure patients. However, patients continue to have high readmission rates due to complications ranging from bleeding, thrombosis, heart failure, and infection. Considering that the hallmark benefit of LVAD therapy is improvement in hemodynamics (cardiac unloading and increased cardiac output), hemodynamic assessment on LVAD support is key to better understand these difficult complications and may serve as a tool to resolving them. In this review, we will discuss the hemodynamic changes following LVAD implantation, and the implications and prognostic impact of hemodynamic optimization on outcomes and complications.

Keywords: Heart failure; HeartMate; Left ventricular assist device; Ramp.

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Figures

Fig. 1
Fig. 1
Continuous-flow left ventricular assist device available in Japan and the USA.
Fig. 2
Fig. 2
Non-invasive devices to monitor hemodynamics.
Fig. 3
Fig. 3
Relationship of CVP and PCWP in each patient at baseline, final, step 0 (lowest speed), and step 9 (highest speed). Reprinted from [8] with permission from Elsevier. CVP, central venous pressure; PCWP, pulmonary capillary wedge pressure.
See this image and copyright information in PMC

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