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Role of long‐term mechanical circulatory support in patients with advanced heart failure
Author(s) -
Stokes M. B.,
Bergin P.,
McGiffin D.
Publication year - 2016
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.12817
Subject(s) - medicine , heart failure , destination therapy , circulatory system , heart transplantation , ventricular assist device , bridge to transplantation , artificial heart , intensive care medicine , transplantation , complication , implant , cardiology , referral , surgery , family medicine
Advanced heart failure represents a small proportion of patients with heart failure that possess high‐risk features associated with high hospital readmission rates, significant functional impairment and mortality. Identification of those who have progressed to, or are near a state of advanced heart failure should prompt referral to a service that offers therapies in mechanical circulatory support ( MCS ) and cardiac transplantation. MCS has grown as a management strategy in the care of these patients, most commonly as a bridge to cardiac transplantation. The predominant utilisation of MCS is implantation of left ventricular assist devices ( LVAD ), which have evolved significantly in their technology and application over the past 15–20 years. The technology has evolved to such an extent that Destination Therapy is now being utilised as a strategy in management of advanced heart failure in appropriately selected patients. Complication rates have decreased with VAD implantation, but remain a significant consideration in the decision to implant a device, and in the follow up of these patients.