Left Ventricular Assist Devices: The What and the Who Lance E. Sullenberger MD FACC FACP Capital Cardiology Associates

US Heart Transplants StableBut Heart Failure Increasing…

Left Ventricular Assist Device Pulsatile Flow Not a true artificial heart. Assists the left ventricle in passing oxygenated blood through the body. Initially was a pulsatile device (similar to native heart…)

Left Ventricular Assist Device Continuous (Axial) Flow

Pulsatile Flow is Out Axial Flow is In

The Down Side Infection Bleeding Thrombosis Embolism Battery issues Hemolysis

Who Gets an LVAD? Bridge to Recovery Bridge to Transplant Destination Therapy

Bridge to Recovery Acute Myocarditis Acute Myocardial Infarction Peripartum Cardiomyopathy Younger Previously healthy Few comorbidities

Bridge to Transplant

Destination Therapy REMATCH Trial 129 patients Ineligible for cardiac transplant Class IV CHF ½ received LVAD ½ received medical therapy alone Can’t get a TX – Older – Hepatitis – DM with small vessel disease Might not get a TX – Renal issues – PHTN Complex surgical

Warning Signs!!

Inability to Take CHF Therapy

Low Sodium

Cardiorenal Syndrome

Warning Signs! Recurrent Admissions Low Blood Pressure Hyponatremia Poor Renal Function Use of Continuous Inotropes Increasing diuretic dose Worsening Heart Failure Class

Bring It Home….

LANCE SULLENBERGER MD Thank You!!!