Mechanical Circulatory Support Devices HOSEIN PASANDI

Heart Failure The Heart Is Unable To Pump And Maintain Blood Flow

Causes of Heart Failure Coronary Artery Disease Myocardial Infarction Hypertension Abnormal Heart Valves Cardiomyopathy Congenital Heart Disease Severe Lung Disease Diabetes

Heart Failure Epidemiology: 5 million Americans,10 million worldwide 500,000 to 1 million new cases yearly 70% of men, 79% of women with CHF have history of hypertension Huge economic impact

Devices and Surgical Procedures to Treat HF ICD (Implantable cardioverter defibrillator ) CRT (Cardiac Resynchronization Therapy ) VAD (ventricular assist device)

Mechanical Circulatory Support Devices MCS devices are artificial devices that perform some or all of the functions of the heart.

MCS Devices Indication Advanced heart Failure Bridges To Cardiac Transplant Bridges To Recovery Support Cardiac Function Before Ht support the LV or RV or both, restore circulation to the tissues, improving organ function

Classification of Mechanical Assist Devices By Indication Urgent Emergent By Duration of Therapy Short term Long term By Degree of Support Provided Augmentation Total support

MCS Component Pumps External battry System controller Outflow graft (cannula) inflow graft (cannula)

Percutaneous Mechanical Support Devices Extracorporeal Devices

Sergical Mechanical Support Devices Intracorporeal Devices

Mechanical circulatory assist devices LVADs (Support LV function) RVADs (Support RV function) BiVAD (Support LV & RV) IMPELLA IABP ECMO Total Artificial Heart (TAH)

INTRA AORTIC BALLON PUMP

IABP INDICATION Easily Placed Improve Coronary Perfusion Decrease Afterload & Preload Decrease Myocardial Demand Transport Patient

IABP CONTRANDICATION Severe Athrosclerosis Severe AR Limited Sopport Tachycardia And Arrythmia

Tandemheart Advantage Can Be Place Can Supply Up To 5 L/Min Can Be Easily Removed

Tandemheart Disadvantage Requirs Trans-septal Placment LA Puncture Causing Tamponade Mechanical Injury To The IVC Potential Of Inter-atrial Shunt

IMPELLA

Indications For The Impella During High-risk PCI Treatment Of Ongoing Cardiogenic Shock

Impella Advantage Small Rotary Pump Place Percutaneos Femoral Artry Easily Removed Unloading Of The Left Ventricle Reducing LVED Pressure Decreasing Myocardial O2 Demand. Increases Coronary And Systemic

Impella Disadvantage Hemolysis Provide Partial Co Support Aortic Valve Injury Aortic Valve Insufficiency LV Puncture Ventricular Arrhythmias

ECMO

Types Of ECMO 1)Venous -Venous ECMO [VV-ECMO] Pulmonary failure 2) Venous - arterial ECMO [VA ECMO] Cardiopulmonary failure

ECMO ADVANTAGE Cardiopulmonary ByPass Support Placed Priferally Biventricular Support

ECMO DISADVANTAGE Require Train Team Thrombosis of the ECMO circuit Systemic gas embolism Failure of oxygenator Bleeding Vascular Injery

HeartMate

HeartMate LVAD Providing Several Years Of Circulatory Support Implantation Requires Surgical Procedure Improvement Of Hemodynamics Bridge To Transplant Return Patient Active Living

Biventricular Assist Device

Total Artificial Heart (TAH)

(TAH) is a pump that is surgically installed to provide circulation and replace heart long-term support unable to receive a heart transplant.

Complication Mcs Infection Bleeding Device Failure Or Device Malfunction Arrhythmia Endocarditis Renal Failure Hemolysis Anemia