Complications of Durable Left Ventricular Assist Device Therapy

Crit Care Clin. 2018 Jul;34(3):465-477. doi: 10.1016/j.ccc.2018.03.003.

Abstract

Heart failure patients on durable left ventricular assist device support experience improved survival, quality of life, and exercise capacity. The complication rate, however, remains unacceptably high, although it has declined with improvements in pump design, better patient selection, and greater understanding of the pump physiology and flow dynamics. Most complications are categorized as those related to the pump-patient interface or those related to patient physiology. It is hoped that further engineering progress, and better patient selection through risk stratification, will allow for left ventricular assist device to be totally biocompatible and perform effectively, without affecting biology and homeostasis of the different organ systems.

Keywords: Complications; GI bleeding; Hemocompatibility; Infection; Neurologic events.

Publication types

  • Review

MeSH terms

  • Aortic Valve Insufficiency / etiology
  • Arrhythmias, Cardiac / etiology
  • Heart Failure / etiology
  • Heart Failure / therapy*
  • Heart-Assist Devices / adverse effects*
  • Humans
  • Infections / etiology*
  • Mitral Valve Insufficiency / etiology
  • Stroke / etiology
  • Thrombosis / etiology*
  • Ventricular Dysfunction, Left / therapy
  • Ventricular Dysfunction, Right / etiology
  • von Willebrand Diseases / etiology*