- 1. School of Clinical Medicine, Weifang Medical University, Weifang, 261053, Shandong, P. R. China;
- 2. Department of Cardiovascular Surgery, The Affiliated Hospital of Weifang Medical University, Weifang, 261031, Shandong, P. R. China;
HOU Wenming,
Email: houdoc815@126.com
The implantation of a left ventricular assist device (LVAD) is an important therapeutic tool for patients with end-stage heart failure, which can either help patients transition to the heart transplantation stage or serve as destination therapy until the end of their lives. In recent years, the third generation of LVADs has evolved rapidly and several brands have been marketed both domestically and internationally. The number of LVAD implantations has been increasing and the long-term survival rate of implanted patients has been improving, so this device has a broad development perspective. This paper summarizes the current status of the development of LVAD and its problems, and is expected to be helpful to researchers who are approaching the field for the first time.
| 1. | 中国医师协会心力衰竭专业委员会, 国家心血管病专家委员会心力衰竭专业委员会, 中华心力衰竭和心肌病杂志编辑委员会. 心力衰竭生物标志物临床应用中国专家共识. 中华心力衰竭和心肌病杂志, 2022, 6(3): 175-192. |
| 2. | DeBakey ME. Left ventricular bypass pump for cardiac assistance. Clinical experience. Am J Cardiol, 1971, 27(1): 3-11. |
| 3. | Rose EA, Gelijns AC, Moskowitz AJ, et al. Long-term use of a left ventricular assist device for end-stage heart failure. N Engl J Med, 2001, 345(20): 1435-1443. |
| 4. | Long JW, Healy AH, Rasmusson BY, et al. Improving outcomes with long-term "destination" therapy using left ventricular assist devices. J Thorac Cardiovasc Surg, 2008, 135(6): 1353-1360. |
| 5. | Lietz K, Long JW, Kfoury AG, et al. Outcomes of left ventricular assist device implantation as destination therapy in the post-REMATCH era: Implications for patient selection. Circulation, 2007, 116(5): 497-505. |
| 6. | Mancini D, Colombo PC. Left ventricular assist devices: A rapidly evolving alternative to transplant. J Am Coll Cardiol, 2015, 65(23): 2542-2555. |
| 7. | Slaughter MS, Rogers JG, Milano CA, et al. Advanced heart failure treated with continuous-flow left ventricular assist device. N Engl J Med, 2009, 361(23): 2241-2251. |
| 8. | Zhang RS, Hanff TC, Peters CJ, et al. Left ventricular assist device as a bridge to recovery: Single center experience of successful device explantation. ASAIO J, 2022, 68(6): 822-828. |
| 9. | Kurihara C, Kawabori M, Sugiura T, et al. Bridging to a long-term ventricular assist device with short-term mechanical circulatory support. Artif Organs, 2018, 42(6): 589-596. |
| 10. | Zuin M, Rigatelli G, Braggion G, et al. Cavitation in left ventricular assist device patients: A potential early sign of pump thrombosis. Heart Fail Rev, 2020, 25(6): 965-972. |
| 11. | Uriel N, Han J, Morrison KA, et al. Device thrombosis in HeartMateⅡcontinuous-flow left ventricular assist devices: A multifactorial phenomenon. J Heart Lung Transplant, 2014, 33(1): 51-59. |
| 12. | Xie A, Phan K, Yan TD. Durability of continuous-flow left ventricular assist devices: A systematic review. Ann Cardiothorac Surg, 2014, 3(6): 547-556. |
| 13. | Gustafsson F, Shaw S, Lavee J, et al. Six-month outcomes after treatment of advanced heart failure with a full magnetically levitated continuous flow left ventricular assist device: Report from the ELEVATE registry. Eur Heart J, 2018, 39(37): 3454-3460. |
| 14. | Zimpfer D, Gustafsson F, Potapov E, et al. Two-year outcome after implantation of a full magnetically levitated left ventricular assist device: Results from the ELEVATE Registry. Eur Heart J, 2020, 41(39): 3801-3809. |
| 15. | Rogers JG, Pagani FD, Tatooles AJ, et al. Intrapericardial left ventricular assist device for advanced heart failure. N Engl J Med, 2017, 376(5): 451-460. |
| 16. | 卿平, 杜娟, 周星彤, 等. 中国左心室辅助装置候选者术前评估与管理专家共识(2023年). 中国循环杂志, 2023, 38(8): 799-814. |
| 17. | Gustafsson F, Rogers JG. Left ventricular assist device therapy in advanced heart failure: Patient selection and outcomes. Eur J Heart Fail, 2017, 19(5): 595-602. |
| 18. | Yuzefpolskaya M, Schroeder SE, Houston BA, et al. The Society of Thoracic Surgeons Intermacs 2022 Annual Report: Focus on the 2018 heart transplant allocation system. Ann Thorac Surg, 2023, 115(2): 311-327. |
| 19. | Molina EJ, Shah P, Kiernan MS, et al. The Society of Thoracic Surgeons Intermacs 2020 Annual Report. Ann Thorac Surg, 2021, 111(3): 778-792. |
| 20. | Walenga JM, Torres TA, Jeske WP, et al. Protein C pathway, inflammation, and pump thrombosis in patients with left ventricular assist devices. Clin Appl Thromb Hemost, 2020, 26: 1076029620959724. |
| 21. | Elasfar A, Jalali K, Hussein M, et al. Discontinuation of anticoagulant therapy for a month in a patient with HeartMateⅢ continuous-flow left ventricular assist device without thromboembolic events. J Saudi Heart Assoc, 2018, 30(3): 268-270. |
| 22. | Fiedler AG, Hermsen JL, Smith JW, et al. Long-term discontinuation of warfarin in a patient with HeartMate3 left ventricular assist device without complication. J Card Surg, 2020, 35(2): 447-449. |
| 23. | Koval CE, Thuita L, Moazami N, et al. Evolution and impact of drive-line infection in a large cohort of continuous-flow ventricular assist device recipients. J Heart Lung Transplant, 2014, 33(11): 1164-1172. |
| 24. | Zhu T, Dufendach KA, Hong Y, et al. Infectious complications following contemporary left ventricular assist device implantation. J Card Surg, 2022, 37(8): 2297-2306. |
| 25. | Seretny J, Pidborochynski T, Buchholz H, et al. Decreasing driveline infections in patients supported on ventricular assist devices: A care pathway approach. BMJ Open Qual, 2022, 11(2): e001815. |
| 26. | Martin BJ, Luc JGY, Maruyama M, et al. Driveline site is not a predictor of infection after ventricular assist device implantation. ASAIO J, 2018, 64(5): 616-622. |
| 27. | Zinoviev R, Lippincott CK, Keller SC, et al. In full flow: Left ventricular assist device infections in the modern era. Open Forum Infect Dis, 2020, 7(5): ofaa124. |
| 28. | Pavlovic NV, Randell T, Madeira T, et al. Risk of left ventricular assist device driveline infection: A systematic literature review. Heart Lung, 2019, 48(2): 90-104. |
| 29. | Boyle AJ, Jorde UP, Sun B, et al. Pre-operative risk factors of bleeding and stroke during left ventricular assist device support: An analysis of more than 900 HeartMateⅡ outpatients. J Am Coll Cardiol, 2014, 63(9): 880-888. |
| 30. | Eisen HJ. Left ventricular assist devices (LVADS): History, clinical application and complications. Korean Circ J, 2019, 49(7): 568-585. |
| 31. | Kataria R, Jorde UP. Gastrointestinal bleeding during continuous-flow left ventricular assist device support: State of the field. Cardiol Rev, 2019, 27(1): 8-13. |
| 32. | Carlson LA, Maynes EJ, Choi JH, et al. Characteristics and outcomes of gastrointestinal bleeding in patients with continuous-flow left ventricular assist devices: A systematic review. Artif Organs, 2020, 44(11): 1150-1161. |
| 33. | Converse MP, Sobhanian M, Taber DJ, et al. Effect of angiotensin Ⅱ inhibitors on gastrointestinal bleeding in patients with left ventricular assist devices. J Am Coll Cardiol, 2019, 73(14): 1769-1778. |
| 34. | Namdaran P, Zikos TA, Pan JY, et al. Thalidomide use reduces risk of refractory gastrointestinal bleeding in patients with continuous flow left ventricular assist devices. ASAIO J, 2020, 66(6): 645-651. |
| 35. | Wilson TJ, Baran DA, Herre JM, et al. Gastrointestinal bleeding rates in left ventricular assist device population reduced with octreotide utilization. ASAIO J, 2021, 67(9): 989-994. |
| 36. | Cornwell WK, Ambardekar AV, Tran T, et al. Stroke incidence and impact of continuous-flow left ventricular assist devices on cerebrovascular physiology. Stroke, 2019, 50(2): 542-548. |
| 37. | Frontera JA, Starling R, Cho SM, et al. Risk factors, mortality, and timing of ischemic and hemorrhagic stroke with left ventricular assist devices. J Heart Lung Transplant, 2017, 36(6): 673-683. |
| 38. | Chiang YP, Cox D, Schroder JN, et al. Stroke risk following implantation of current generation centrifugal flow left ventricular assist devices. J Card Surg, 2020, 35(2): 383-389. |
| 39. | Giede-Jeppe A, Roeder SS, Macha K, et al. Management of stroke in patients with left ventricular assist devices. J Stroke Cerebrovasc Dis, 2020, 29(11): 105166. |
| 40. | Chivukula VK, Beckman JA, Prisco AR, et al. Left ventricular assist device inflow cannula angle and thrombosis risk. Circ Heart Fail, 2018, 11(4): e004325. |
| 41. | Chivukula VK, Beckman JA, Li S, et al. Left ventricular assist device inflow cannula insertion depth influences thrombosis risk. ASAIO J, 2020, 66(7): 766-773. |
| 42. | May-Newman K, Montes R, Campos J, et al. Reducing regional flow stasis and improving intraventricular hemodynamics with a tipless inflow cannula design: An in vitro flow visualization study using the EVAHEART LVAD. Artif Organs, 2019, 43(9): 834-848. |
| 43. | Gopinathannair R, Cornwell WK, Dukes JW, et al. Device therapy and arrhythmia management in left ventricular assist device recipients: A scientific statement from the American Heart Association. Circulation, 2019, 139(20): e967-e989. |
| 44. | Gulletta S, Scandroglio AM, Pannone L, et al. Clinical characteristics and outcomes of patients with ventricular arrhythmias after continuous-flow left ventricular assist device implant. Artif Organs, 2022, 46(8): 1608-1615. |
| 45. | Frankfurter C, Molinero M, Vishram-Nielsen JKK, et al. Predicting the risk of right ventricular failure in patients undergoing left ventricular assist device implantation: A systematic review. Circ Heart Fail, 2020, 13(10): e006994. |
| 46. | Gudejko MD, Gebhardt BR, Zahedi F, et al. Intraoperative hemodynamic and echocardiographic measurements associated with severe right ventricular failure after left ventricular assist device implantation. Anesth Analg, 2019, 128(1): 25-32. |
| 47. | Raymer DS, Moreno JD, Sintek MA, et al. The combination of tricuspid annular plane systolic excursion and heartmaterisk score predicts right ventricular failure after left ventricular assist device implantation. ASAIO J, 2019, 65(3): 247-251. |
| 48. | Lo Coco V, De Piero ME, Massimi G, et al. Right ventricular failure after left ventricular assist device implantation: a review of the literature. J Thorac Dis, 2021, 13(2): 1256-1269. |
| 49. | Ali HR, Kiernan MS, Choudhary G, et al. Right ventricular failure post-implantation of left ventricular assist device: Prevalence, pathophysiology, and predictors. ASAIO J, 2020, 66(6): 610-619. |
| 50. | Lampert BC, Teuteberg JJ. Right ventricular failure after left ventricular assist devices. J Heart Lung Transplant, 2015, 34(9): 1123-1130. |
| 51. | Gulati G, Grandin EW, Kennedy K, et al. Preimplant phosphodiesterase-5 inhibitor use is associated with higher rates of severe early right heart failure after left ventricular assist device implantation. Circ Heart Fail, 2019, 12(6): e005537. |
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- 1. 中国医师协会心力衰竭专业委员会, 国家心血管病专家委员会心力衰竭专业委员会, 中华心力衰竭和心肌病杂志编辑委员会. 心力衰竭生物标志物临床应用中国专家共识. 中华心力衰竭和心肌病杂志, 2022, 6(3): 175-192.
- 2. DeBakey ME. Left ventricular bypass pump for cardiac assistance. Clinical experience. Am J Cardiol, 1971, 27(1): 3-11.
- 3. Rose EA, Gelijns AC, Moskowitz AJ, et al. Long-term use of a left ventricular assist device for end-stage heart failure. N Engl J Med, 2001, 345(20): 1435-1443.
- 4. Long JW, Healy AH, Rasmusson BY, et al. Improving outcomes with long-term "destination" therapy using left ventricular assist devices. J Thorac Cardiovasc Surg, 2008, 135(6): 1353-1360.
- 5. Lietz K, Long JW, Kfoury AG, et al. Outcomes of left ventricular assist device implantation as destination therapy in the post-REMATCH era: Implications for patient selection. Circulation, 2007, 116(5): 497-505.
- 6. Mancini D, Colombo PC. Left ventricular assist devices: A rapidly evolving alternative to transplant. J Am Coll Cardiol, 2015, 65(23): 2542-2555.
- 7. Slaughter MS, Rogers JG, Milano CA, et al. Advanced heart failure treated with continuous-flow left ventricular assist device. N Engl J Med, 2009, 361(23): 2241-2251.
- 8. Zhang RS, Hanff TC, Peters CJ, et al. Left ventricular assist device as a bridge to recovery: Single center experience of successful device explantation. ASAIO J, 2022, 68(6): 822-828.
- 9. Kurihara C, Kawabori M, Sugiura T, et al. Bridging to a long-term ventricular assist device with short-term mechanical circulatory support. Artif Organs, 2018, 42(6): 589-596.
- 10. Zuin M, Rigatelli G, Braggion G, et al. Cavitation in left ventricular assist device patients: A potential early sign of pump thrombosis. Heart Fail Rev, 2020, 25(6): 965-972.
- 11. Uriel N, Han J, Morrison KA, et al. Device thrombosis in HeartMateⅡcontinuous-flow left ventricular assist devices: A multifactorial phenomenon. J Heart Lung Transplant, 2014, 33(1): 51-59.
- 12. Xie A, Phan K, Yan TD. Durability of continuous-flow left ventricular assist devices: A systematic review. Ann Cardiothorac Surg, 2014, 3(6): 547-556.
- 13. Gustafsson F, Shaw S, Lavee J, et al. Six-month outcomes after treatment of advanced heart failure with a full magnetically levitated continuous flow left ventricular assist device: Report from the ELEVATE registry. Eur Heart J, 2018, 39(37): 3454-3460.
- 14. Zimpfer D, Gustafsson F, Potapov E, et al. Two-year outcome after implantation of a full magnetically levitated left ventricular assist device: Results from the ELEVATE Registry. Eur Heart J, 2020, 41(39): 3801-3809.
- 15. Rogers JG, Pagani FD, Tatooles AJ, et al. Intrapericardial left ventricular assist device for advanced heart failure. N Engl J Med, 2017, 376(5): 451-460.
- 16. 卿平, 杜娟, 周星彤, 等. 中国左心室辅助装置候选者术前评估与管理专家共识(2023年). 中国循环杂志, 2023, 38(8): 799-814.
- 17. Gustafsson F, Rogers JG. Left ventricular assist device therapy in advanced heart failure: Patient selection and outcomes. Eur J Heart Fail, 2017, 19(5): 595-602.
- 18. Yuzefpolskaya M, Schroeder SE, Houston BA, et al. The Society of Thoracic Surgeons Intermacs 2022 Annual Report: Focus on the 2018 heart transplant allocation system. Ann Thorac Surg, 2023, 115(2): 311-327.
- 19. Molina EJ, Shah P, Kiernan MS, et al. The Society of Thoracic Surgeons Intermacs 2020 Annual Report. Ann Thorac Surg, 2021, 111(3): 778-792.
- 20. Walenga JM, Torres TA, Jeske WP, et al. Protein C pathway, inflammation, and pump thrombosis in patients with left ventricular assist devices. Clin Appl Thromb Hemost, 2020, 26: 1076029620959724.
- 21. Elasfar A, Jalali K, Hussein M, et al. Discontinuation of anticoagulant therapy for a month in a patient with HeartMateⅢ continuous-flow left ventricular assist device without thromboembolic events. J Saudi Heart Assoc, 2018, 30(3): 268-270.
- 22. Fiedler AG, Hermsen JL, Smith JW, et al. Long-term discontinuation of warfarin in a patient with HeartMate3 left ventricular assist device without complication. J Card Surg, 2020, 35(2): 447-449.
- 23. Koval CE, Thuita L, Moazami N, et al. Evolution and impact of drive-line infection in a large cohort of continuous-flow ventricular assist device recipients. J Heart Lung Transplant, 2014, 33(11): 1164-1172.
- 24. Zhu T, Dufendach KA, Hong Y, et al. Infectious complications following contemporary left ventricular assist device implantation. J Card Surg, 2022, 37(8): 2297-2306.
- 25. Seretny J, Pidborochynski T, Buchholz H, et al. Decreasing driveline infections in patients supported on ventricular assist devices: A care pathway approach. BMJ Open Qual, 2022, 11(2): e001815.
- 26. Martin BJ, Luc JGY, Maruyama M, et al. Driveline site is not a predictor of infection after ventricular assist device implantation. ASAIO J, 2018, 64(5): 616-622.
- 27. Zinoviev R, Lippincott CK, Keller SC, et al. In full flow: Left ventricular assist device infections in the modern era. Open Forum Infect Dis, 2020, 7(5): ofaa124.
- 28. Pavlovic NV, Randell T, Madeira T, et al. Risk of left ventricular assist device driveline infection: A systematic literature review. Heart Lung, 2019, 48(2): 90-104.
- 29. Boyle AJ, Jorde UP, Sun B, et al. Pre-operative risk factors of bleeding and stroke during left ventricular assist device support: An analysis of more than 900 HeartMateⅡ outpatients. J Am Coll Cardiol, 2014, 63(9): 880-888.
- 30. Eisen HJ. Left ventricular assist devices (LVADS): History, clinical application and complications. Korean Circ J, 2019, 49(7): 568-585.
- 31. Kataria R, Jorde UP. Gastrointestinal bleeding during continuous-flow left ventricular assist device support: State of the field. Cardiol Rev, 2019, 27(1): 8-13.
- 32. Carlson LA, Maynes EJ, Choi JH, et al. Characteristics and outcomes of gastrointestinal bleeding in patients with continuous-flow left ventricular assist devices: A systematic review. Artif Organs, 2020, 44(11): 1150-1161.
- 33. Converse MP, Sobhanian M, Taber DJ, et al. Effect of angiotensin Ⅱ inhibitors on gastrointestinal bleeding in patients with left ventricular assist devices. J Am Coll Cardiol, 2019, 73(14): 1769-1778.
- 34. Namdaran P, Zikos TA, Pan JY, et al. Thalidomide use reduces risk of refractory gastrointestinal bleeding in patients with continuous flow left ventricular assist devices. ASAIO J, 2020, 66(6): 645-651.
- 35. Wilson TJ, Baran DA, Herre JM, et al. Gastrointestinal bleeding rates in left ventricular assist device population reduced with octreotide utilization. ASAIO J, 2021, 67(9): 989-994.
- 36. Cornwell WK, Ambardekar AV, Tran T, et al. Stroke incidence and impact of continuous-flow left ventricular assist devices on cerebrovascular physiology. Stroke, 2019, 50(2): 542-548.
- 37. Frontera JA, Starling R, Cho SM, et al. Risk factors, mortality, and timing of ischemic and hemorrhagic stroke with left ventricular assist devices. J Heart Lung Transplant, 2017, 36(6): 673-683.
- 38. Chiang YP, Cox D, Schroder JN, et al. Stroke risk following implantation of current generation centrifugal flow left ventricular assist devices. J Card Surg, 2020, 35(2): 383-389.
- 39. Giede-Jeppe A, Roeder SS, Macha K, et al. Management of stroke in patients with left ventricular assist devices. J Stroke Cerebrovasc Dis, 2020, 29(11): 105166.
- 40. Chivukula VK, Beckman JA, Prisco AR, et al. Left ventricular assist device inflow cannula angle and thrombosis risk. Circ Heart Fail, 2018, 11(4): e004325.
- 41. Chivukula VK, Beckman JA, Li S, et al. Left ventricular assist device inflow cannula insertion depth influences thrombosis risk. ASAIO J, 2020, 66(7): 766-773.
- 42. May-Newman K, Montes R, Campos J, et al. Reducing regional flow stasis and improving intraventricular hemodynamics with a tipless inflow cannula design: An in vitro flow visualization study using the EVAHEART LVAD. Artif Organs, 2019, 43(9): 834-848.
- 43. Gopinathannair R, Cornwell WK, Dukes JW, et al. Device therapy and arrhythmia management in left ventricular assist device recipients: A scientific statement from the American Heart Association. Circulation, 2019, 139(20): e967-e989.
- 44. Gulletta S, Scandroglio AM, Pannone L, et al. Clinical characteristics and outcomes of patients with ventricular arrhythmias after continuous-flow left ventricular assist device implant. Artif Organs, 2022, 46(8): 1608-1615.
- 45. Frankfurter C, Molinero M, Vishram-Nielsen JKK, et al. Predicting the risk of right ventricular failure in patients undergoing left ventricular assist device implantation: A systematic review. Circ Heart Fail, 2020, 13(10): e006994.
- 46. Gudejko MD, Gebhardt BR, Zahedi F, et al. Intraoperative hemodynamic and echocardiographic measurements associated with severe right ventricular failure after left ventricular assist device implantation. Anesth Analg, 2019, 128(1): 25-32.
- 47. Raymer DS, Moreno JD, Sintek MA, et al. The combination of tricuspid annular plane systolic excursion and heartmaterisk score predicts right ventricular failure after left ventricular assist device implantation. ASAIO J, 2019, 65(3): 247-251.
- 48. Lo Coco V, De Piero ME, Massimi G, et al. Right ventricular failure after left ventricular assist device implantation: a review of the literature. J Thorac Dis, 2021, 13(2): 1256-1269.
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