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Review
. 2022 Mar 22;79(11):1092-1107.
doi: 10.1016/j.jacc.2022.01.017.

Trends and Outcomes of Left Ventricular Assist Device Therapy: JACC Focus Seminar

Anubodh S Varshney  1 , Ersilia M DeFilippis  2 , Jennifer A Cowger  3 , Ivan Netuka  4 , Sean P Pinney  5 , Michael M Givertz  6
Affiliations
Free article
Review

Trends and Outcomes of Left Ventricular Assist Device Therapy: JACC Focus Seminar

Anubodh S Varshney et al. J Am Coll Cardiol. .
Free article

Abstract

As the prevalence of advanced heart failure continues to rise, treatment strategies for select patients include heart transplantation or durable left ventricular assist device (LVAD) support, both of which improve quality of life and extend survival. Recently, the HeartMate 3 has been incorporated into clinical practice, the United Network for Organ Sharing donor heart allocation system was revised, and the management of LVAD-related complications has evolved. Contemporary LVAD recipients have greater preoperative illness severity, but survival is higher and adverse event rates are lower compared with prior eras. This is driven by advances in device design, patient selection, surgical techniques, and long-term management. However, bleeding, infection, neurologic events, and right ventricular failure continue to limit broader implementation of LVAD support. Ongoing efforts to optimize management of patients implanted with current devices and parallel development of next-generation devices are likely to further improve outcomes for patients with advanced heart failure.

Keywords: advanced heart failure; hemocompatibility-related adverse events; left ventricular assist device; mechanical circulatory support.

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Conflict of interest statement

Funding Support and Author Disclosures Dr Varshney has received support from the National Heart, Lung, and Blood Institute T32 postdoctoral training grant T32HL007604 and the Daniel Pierce Family Fellowship in Advanced Heart Disease; has served on an advisory board for Broadview Ventures; and has received consulting fees from Buoy Health, Inc. Dr Cowger has served on an advisory board for Abbott; has received speaker fees from Abbott and Zoll; has been a consultant and national principal investigator for HVAD DT PAS; has been a steering committee member for Endotronix (unpaid) and Procyrion; and has stock options in Procyrion. Dr Netuka has been a consultant for and received institutional grant support from Abbott Laboratories and Carmat SA, France; has been an advisory board member for Abbott Laboratories, U.S.A.; and has been a board member and stockholder of LeviticusCardio Ltd, Israel. Dr Pinney has received consulting fees from Abbott, CareDx, Medtronic, Procyrion, and TransMedics. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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