Application status and development of left ventricular assist devices in ischemic heart failure patients_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHAO Shuanglei , WEN Mingxiu , LI Qianxian , HU Yi , LIU Zhou , ZHANG Hongjia ,  GONG Ming

Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, P. R. China;

Corresponding author：

GONG Ming, Email: gongming817@hotmail.com

Keywords：

Left ventricular assist device; heart failure; ischemic cardiomyopathy; review

DOI：

10.7507/1007-4848.202312085

Video：

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In China, more than half of heart failure patients are ischemic heart failure patients. And a large proportion of left ventricular assist device implantation patients are also ischemic heart failure patients. However, left ventricular assist device implantation in ischemic heart failure patients is facing with problems such as patient screening, coronary artery disease, small left ventricle, mitral insufficiency, and ventricular aneurysm. There are only a few retrospective studies with small sample sizes abroad trying to provide solutions to these problems. While there is a lack of systematic understanding of this issue in China. Therefore, we provide an overview of the application and progress of left ventricular assist devices in ischemic heart failure patients, aiming to help clinicians have a comprehensive understanding of this issue and provide some guidance.

Citation： ZHAO Shuanglei, WEN Mingxiu, LI Qianxian, HU Yi, LIU Zhou, ZHANG Hongjia, GONG Ming. Application status and development of left ventricular assist devices in ischemic heart failure patients. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(11): 1663-1669. doi: 10.7507/1007-4848.202312085 Copy

1.	Bragazzi NL, Zhong W, Shu J, et al. Burden of heart failure and underlying causes in 195 countries and territories from 1990 to 2017. Eur J Prev Cardiol, 2021, 28(15): 1682-1690.
2.	中国心衰中心联盟, 苏州工业园区心血管健康研究院, 中国心血管健康联盟中国. 中国心衰中心工作报告 (2021)—心力衰竭患者的诊疗现况.中国介入心脏病学杂志, 2022, 30(5): 328-336.China Heart Failure Center Alliance, Suzhou Industrial Park Cardiovascular Health Research Institute, China Cardiovascular Health Alliance. China work report of China Heart Failure Center (2021)—Diagnosis and treatment status of heart failure patients. Chin J Interv Cardiol, 2022, 30(5): 328-336.
3.	沈李阳, 陆曙, 程亮. 缺血性心肌病的中西医结合治疗研究进展. 中西医结合心血管病电子杂志, 2021, 9(29): 20-21.Shen LY, Lu S, Cheng L. Research progress on integrated traditional Chinese and Western medicine treatment of ischemic cardiomyopathy. Cardiovasc Dis Electron J Tradit Integr Chin West Med, 2021, 9(29): 20-21.
4.	Cybulska B, Kłosiewicz-Latoszek L. Landmark studies in coronary heart disease epidemiology. The Framingham heart study after 70 years and the seven countries study after 60 years. Kardiol Pol, 2019, 77(2): 173-180.
5.	Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: Executive summary: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 2022, 145(18): e876-e894.
6.	赵双雷, 刘彤, 温明修, 等. 植入式左心室辅助装置在我国的应用与发展. 中国医刊, 2023, 58(12): 1282-1285.Zhao SL, Liu T, Wen MX, et al. Application and development of implantable left ventricular assist device in China. Chin Med J, 2023, 58(12): 1282-1285.
7.	Sutton MG, Sharpe N. Left ventricular remodeling after myocardial infarction: Pathophysiology and therapy. Circulation, 2000, 101(25): 2981-2988.
8.	McDonagh TA, Metra M, Adamo M, et al. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J, 2021, 42(36): 3599-3726.
9.	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.
10.	de By TMMH, Schoenrath F, Veen KM, et al. The European registry for patients with mechanical circulatory support of the European Association for Cardio-Thoracic Surgery: Third report. Eur J Cardiothorac Surg, 2022, 62(1): ezac032.
11.	Pagliaro BR, Cannata F, Stefanini GG, et al. Myocardial ischemia and coronary disease in heart failure. Heart Fail Rev, 2020, 25(1): 53-65.
12.	Del Buono MG, Moroni F, Montone RA, et al. Ischemic cardiomyopathy and heart failure after acute myocardial infarction. Curr Cardiol Rep, 2022, 24(10): 1505-1515.
13.	Bakaeen FG, Gaudino M, Whitman G, et al. 2021: The American Association for Thoracic Surgery Expert Consensus Document: Coronary artery bypass grafting in patients with ischemic cardiomyopathy and heart failure. J Thorac Cardiovasc Surg, 2021, 162(3): 829-850.
14.	Neumann FJ, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTS guidelines on myocardial revascularization. Eur Heart J, 2019, 40(2): 87-165.
15.	Hocum Stone LL, Swingen C, Wright C, et al. Recovery of hibernating myocardium using stem cell patch with coronary bypass surgery. J Thorac Cardiovasc Surg, 2021, 162(1): e3-e16.
16.	Schinkel AF, Poldermans D, Vanoverschelde JL, et al. Incidence of recovery of contractile function following revascularization in patients with ischemic left ventricular dysfunction. Am J Cardiol, 2004, 93(1): 14-17.
17.	D'Egidio G, Nichol G, Williams KA, et al. Increasing benefit from revascularization is associated with increasing amounts of myocardial hibernation: A substudy of the PARR-2 trial. JACC Cardiovasc Imaging, 2009, 2(9): 1060-1068.
18.	杨彦松. 存活心肌数量预测冠状动脉旁路移植术后左心室射血分数改善和左心室容积减小的价值. 苏州大学, 2016.Yang YS. Amount of viable myocardium assessed by combining 99mTc-MIBI SPECT and 18F-FDG PET enable to predict leftventricular ejection fraction improvement and left ventricular volume reduction after coronary artery bypass surgery. Soochow University, 2016.
19.	吴冬冬, 刘志刚, 李剑明, 等. 心肌活力预测缺血性心力衰竭患者冠状动脉旁路移植术后心功能改善的临床研究. 中国胸心血管外科临床杂志, 2020, 27(11): 1314-1319.Wu DD, Liu ZG, Li JM, et al. A clinical study of myocardial viability in predicting the improvement of cardiac function after coronary artery bypass grafting in patients with ischemic heart failure. Chin J Clin Thorac Cardiovasc Surg, 2020, 27(11): 1314-1319.
20.	Kolte D, Khera S, Aronow WS, et al. Trends in incidence, management, and outcomes of cardiogenic shock complicating ST-elevation myocardial infarction in the United States. J Am Heart Assoc, 2014, 3(1): e000590.
21.	Anderson ML, Peterson ED, Peng SA, et al. Differences in the profile, treatment, and prognosis of patients with cardiogenic shock by myocardial infarction classification: A report from NCDR. Circ Cardiovasc Qual Outcomes, 2013, 6(6): 708-715.
22.	Wever-Pinzon J, Selzman CH, Stoddard G, et al. Impact of ischemic heart failure etiology on cardiac recovery during mechanical unloading. J Am Coll Cardiol, 2016, 68(16): 1741-1752.
23.	Potapov EV, Antonides C, Crespo-Leiro MG, et al. 2019 EACTS expert consensus on long-term mechanical circulatory support. Eur J Cardiothorac Surg, 2019, 56(2): 230-270.
24.	Mehta P, Imamura T, Juricek C, et al. Combined left ventricular assist device and coronary artery bypass grafting surgery: Should we bypass the bypass? ASAIO J, 2020, 66(1): 32-37.
25.	Kirklin JK, Pagani FD, Goldstein DJ, et al. American Association for Thoracic Surgery/International Society for Heart and Lung Transplantation guidelines on selected topics in mechanical circulatory support. J Heart Lung Transplant, 2020, 39(3): 187-219.
26.	Shah P, Birk S, Maltais S, et al. Left ventricular assist device outcomes based on flow configuration and pre-operative left ventricular dimension: An interagency registry for mechanically assisted circulatory support analysis. J Heart Lung Transplant, 2017, 36(6): 640-649.
27.	Kawabori M, Kurihara C, Conyer R, et al. A left ventricular end-diastolic dimension less than 6.0 cm is associated with mortality after implantation of an axial-flow pump. J Thorac Cardiovasc Surg, 2019, 157(6): 2302-2310.
28.	Molina E, Jain A, Ahmed S, et al. The impact of left ventricular size on outcomes after centrifugal-flow left ventricular assist device implantation. Eur J Cardiothorac Surg, 2022, 62(1): ezab480.
29.	Noly PE, Duggal N, Jiang M, et al. Role of the mitral valve in left ventricular assist device pathophysiology. Front Cardiovasc Med, 2022, 9: 1018295.
30.	Kanwar MK, Rajagopal K, Itoh A, et al. Impact of left ventricular assist device implantation on mitral regurgitation: An analysis from the MOMENTUM 3 trial. J Heart Lung Transplant, 2020, 39(6): 529-537.
31.	Stulak JM, Tchantchaleishvili V, Haglund NA, et al. Uncorrected pre-operative mitral valve regurgitation is not associated with adverse outcomes after continuous-flow left ventricular assist device implantation. J Heart Lung Transplant, 2015, 34(5): 718-723.
32.	Asgar AW, Mack MJ, Stone GW. Secondary mitral regurgitation in heart failure: Pathophysiology, prognosis, and therapeutic considerations. J Am Coll Cardiol, 2015, 65(12): 1231-1248.
33.	Tanaka A, Onsager D, Song T, et al. Surgically corrected mitral regurgitation during left ventricular assist device implantation is associated with low recurrence rate and improved midterm survival. Ann Thorac Surg, 2017, 103(3): 725-733.
34.	Robertson JO, Naftel DC, Myers SL, et al. Concomitant mitral valve procedures in patients undergoing implantation of continuous-flow left ventricular assist devices: An INTERMACS database analysis. J Heart Lung Transplant, 2018, 37(1): 79-88.
35.	Schaefer A, Schneeberger Y, Castro L, et al. Left ventricular assist device implantation and concomitant Dor procedure: A single center experience. Braz J Cardiovasc Surg, 2020, 35(4): 477-483.
36.	Masarone D, Melillo E, Gravino R, et al. Left ventricular assist device implantation in a thrombosed apical aneurysm. Clin Pract, 2021, 11(3): 430-434.
37.	Haidari Z, Ruhparwar A, Weymann A, et al. Left ventricular assist device implantation in left ventricular aneurysm: The turtleneck technique. JTCVS Tech, 2022, 13: 122-124.
38.	Osaki S, Edwards NM, Kohmoto T. Strategies for left ventricular assist device insertion after the Dor procedure. J Heart Lung Transplant, 2009, 28(5): 520-522.
39.	Chou BP, Critsinelis A, Lamba HK, et al. Continuous-flow left ventricular assist device support in patients with ischemic versus nonischemic cardiomyopathy. Tex Heart Inst J, 2021, 48(4): e207241.
40.	Goldstein DJ, Maybaum S, MacGillivray TE, et al. Young patients with nonischemic cardiomyopathy have higher likelihood of left ventricular recovery during left ventricular assist device support. J Card Fail, 2012, 18(5): 392-395.

1. Bragazzi NL, Zhong W, Shu J, et al. Burden of heart failure and underlying causes in 195 countries and territories from 1990 to 2017. Eur J Prev Cardiol, 2021, 28(15): 1682-1690.
2. 中国心衰中心联盟, 苏州工业园区心血管健康研究院, 中国心血管健康联盟中国. 中国心衰中心工作报告 (2021)—心力衰竭患者的诊疗现况.中国介入心脏病学杂志, 2022, 30(5): 328-336.China Heart Failure Center Alliance, Suzhou Industrial Park Cardiovascular Health Research Institute, China Cardiovascular Health Alliance. China work report of China Heart Failure Center (2021)—Diagnosis and treatment status of heart failure patients. Chin J Interv Cardiol, 2022, 30(5): 328-336.
3. 沈李阳, 陆曙, 程亮. 缺血性心肌病的中西医结合治疗研究进展. 中西医结合心血管病电子杂志, 2021, 9(29): 20-21.Shen LY, Lu S, Cheng L. Research progress on integrated traditional Chinese and Western medicine treatment of ischemic cardiomyopathy. Cardiovasc Dis Electron J Tradit Integr Chin West Med, 2021, 9(29): 20-21.
4. Cybulska B, Kłosiewicz-Latoszek L. Landmark studies in coronary heart disease epidemiology. The Framingham heart study after 70 years and the seven countries study after 60 years. Kardiol Pol, 2019, 77(2): 173-180.
5. Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: Executive summary: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 2022, 145(18): e876-e894.
6. 赵双雷, 刘彤, 温明修, 等. 植入式左心室辅助装置在我国的应用与发展. 中国医刊, 2023, 58(12): 1282-1285.Zhao SL, Liu T, Wen MX, et al. Application and development of implantable left ventricular assist device in China. Chin Med J, 2023, 58(12): 1282-1285.
7. Sutton MG, Sharpe N. Left ventricular remodeling after myocardial infarction: Pathophysiology and therapy. Circulation, 2000, 101(25): 2981-2988.
8. McDonagh TA, Metra M, Adamo M, et al. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J, 2021, 42(36): 3599-3726.
9. 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.
10. de By TMMH, Schoenrath F, Veen KM, et al. The European registry for patients with mechanical circulatory support of the European Association for Cardio-Thoracic Surgery: Third report. Eur J Cardiothorac Surg, 2022, 62(1): ezac032.
11. Pagliaro BR, Cannata F, Stefanini GG, et al. Myocardial ischemia and coronary disease in heart failure. Heart Fail Rev, 2020, 25(1): 53-65.
12. Del Buono MG, Moroni F, Montone RA, et al. Ischemic cardiomyopathy and heart failure after acute myocardial infarction. Curr Cardiol Rep, 2022, 24(10): 1505-1515.
13. Bakaeen FG, Gaudino M, Whitman G, et al. 2021: The American Association for Thoracic Surgery Expert Consensus Document: Coronary artery bypass grafting in patients with ischemic cardiomyopathy and heart failure. J Thorac Cardiovasc Surg, 2021, 162(3): 829-850.
14. Neumann FJ, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTS guidelines on myocardial revascularization. Eur Heart J, 2019, 40(2): 87-165.
15. Hocum Stone LL, Swingen C, Wright C, et al. Recovery of hibernating myocardium using stem cell patch with coronary bypass surgery. J Thorac Cardiovasc Surg, 2021, 162(1): e3-e16.
16. Schinkel AF, Poldermans D, Vanoverschelde JL, et al. Incidence of recovery of contractile function following revascularization in patients with ischemic left ventricular dysfunction. Am J Cardiol, 2004, 93(1): 14-17.
17. D'Egidio G, Nichol G, Williams KA, et al. Increasing benefit from revascularization is associated with increasing amounts of myocardial hibernation: A substudy of the PARR-2 trial. JACC Cardiovasc Imaging, 2009, 2(9): 1060-1068.
18. 杨彦松. 存活心肌数量预测冠状动脉旁路移植术后左心室射血分数改善和左心室容积减小的价值. 苏州大学, 2016.Yang YS. Amount of viable myocardium assessed by combining 99mTc-MIBI SPECT and 18F-FDG PET enable to predict leftventricular ejection fraction improvement and left ventricular volume reduction after coronary artery bypass surgery. Soochow University, 2016.
19. 吴冬冬, 刘志刚, 李剑明, 等. 心肌活力预测缺血性心力衰竭患者冠状动脉旁路移植术后心功能改善的临床研究. 中国胸心血管外科临床杂志, 2020, 27(11): 1314-1319.Wu DD, Liu ZG, Li JM, et al. A clinical study of myocardial viability in predicting the improvement of cardiac function after coronary artery bypass grafting in patients with ischemic heart failure. Chin J Clin Thorac Cardiovasc Surg, 2020, 27(11): 1314-1319.
20. Kolte D, Khera S, Aronow WS, et al. Trends in incidence, management, and outcomes of cardiogenic shock complicating ST-elevation myocardial infarction in the United States. J Am Heart Assoc, 2014, 3(1): e000590.
21. Anderson ML, Peterson ED, Peng SA, et al. Differences in the profile, treatment, and prognosis of patients with cardiogenic shock by myocardial infarction classification: A report from NCDR. Circ Cardiovasc Qual Outcomes, 2013, 6(6): 708-715.
22. Wever-Pinzon J, Selzman CH, Stoddard G, et al. Impact of ischemic heart failure etiology on cardiac recovery during mechanical unloading. J Am Coll Cardiol, 2016, 68(16): 1741-1752.
23. Potapov EV, Antonides C, Crespo-Leiro MG, et al. 2019 EACTS expert consensus on long-term mechanical circulatory support. Eur J Cardiothorac Surg, 2019, 56(2): 230-270.
24. Mehta P, Imamura T, Juricek C, et al. Combined left ventricular assist device and coronary artery bypass grafting surgery: Should we bypass the bypass? ASAIO J, 2020, 66(1): 32-37.
25. Kirklin JK, Pagani FD, Goldstein DJ, et al. American Association for Thoracic Surgery/International Society for Heart and Lung Transplantation guidelines on selected topics in mechanical circulatory support. J Heart Lung Transplant, 2020, 39(3): 187-219.
26. Shah P, Birk S, Maltais S, et al. Left ventricular assist device outcomes based on flow configuration and pre-operative left ventricular dimension: An interagency registry for mechanically assisted circulatory support analysis. J Heart Lung Transplant, 2017, 36(6): 640-649.
27. Kawabori M, Kurihara C, Conyer R, et al. A left ventricular end-diastolic dimension less than 6.0 cm is associated with mortality after implantation of an axial-flow pump. J Thorac Cardiovasc Surg, 2019, 157(6): 2302-2310.
28. Molina E, Jain A, Ahmed S, et al. The impact of left ventricular size on outcomes after centrifugal-flow left ventricular assist device implantation. Eur J Cardiothorac Surg, 2022, 62(1): ezab480.
29. Noly PE, Duggal N, Jiang M, et al. Role of the mitral valve in left ventricular assist device pathophysiology. Front Cardiovasc Med, 2022, 9: 1018295.
30. Kanwar MK, Rajagopal K, Itoh A, et al. Impact of left ventricular assist device implantation on mitral regurgitation: An analysis from the MOMENTUM 3 trial. J Heart Lung Transplant, 2020, 39(6): 529-537.
31. Stulak JM, Tchantchaleishvili V, Haglund NA, et al. Uncorrected pre-operative mitral valve regurgitation is not associated with adverse outcomes after continuous-flow left ventricular assist device implantation. J Heart Lung Transplant, 2015, 34(5): 718-723.
32. Asgar AW, Mack MJ, Stone GW. Secondary mitral regurgitation in heart failure: Pathophysiology, prognosis, and therapeutic considerations. J Am Coll Cardiol, 2015, 65(12): 1231-1248.
33. Tanaka A, Onsager D, Song T, et al. Surgically corrected mitral regurgitation during left ventricular assist device implantation is associated with low recurrence rate and improved midterm survival. Ann Thorac Surg, 2017, 103(3): 725-733.
34. Robertson JO, Naftel DC, Myers SL, et al. Concomitant mitral valve procedures in patients undergoing implantation of continuous-flow left ventricular assist devices: An INTERMACS database analysis. J Heart Lung Transplant, 2018, 37(1): 79-88.
35. Schaefer A, Schneeberger Y, Castro L, et al. Left ventricular assist device implantation and concomitant Dor procedure: A single center experience. Braz J Cardiovasc Surg, 2020, 35(4): 477-483.
36. Masarone D, Melillo E, Gravino R, et al. Left ventricular assist device implantation in a thrombosed apical aneurysm. Clin Pract, 2021, 11(3): 430-434.
37. Haidari Z, Ruhparwar A, Weymann A, et al. Left ventricular assist device implantation in left ventricular aneurysm: The turtleneck technique. JTCVS Tech, 2022, 13: 122-124.
38. Osaki S, Edwards NM, Kohmoto T. Strategies for left ventricular assist device insertion after the Dor procedure. J Heart Lung Transplant, 2009, 28(5): 520-522.
39. Chou BP, Critsinelis A, Lamba HK, et al. Continuous-flow left ventricular assist device support in patients with ischemic versus nonischemic cardiomyopathy. Tex Heart Inst J, 2021, 48(4): e207241.
40. Goldstein DJ, Maybaum S, MacGillivray TE, et al. Young patients with nonischemic cardiomyopathy have higher likelihood of left ventricular recovery during left ventricular assist device support. J Card Fail, 2012, 18(5): 392-395.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Application status and development of left ventricular assist devices in ischemic heart failure patients

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