VENTRICULAR ASSIST DEVICES Edited by Jeff rey H. Shuhaiber Ventricular Assist Devices Edited by Jeffrey H. Shuhaiber Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2011 InTech All chapters are Open Access articles distributed under the Creative Commons Non Commercial Share Alike Attribution 3.0 license, which permits to copy, distribute, transmit, and adapt the work in any medium, so long as the original work is properly cited. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published articles. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Ana Nikolic Technical Editor Teodora Smiljanic Cover Designer Martina Sirotic Image Copyright A1Stock, 2010. Used under license from Shutterstock.com First published March, 2011 Printed in India A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org Ventricular Assist Devices, Edited by Jeffrey H. Shuhaiber p. cm. ISBN 978-953-307-164-0 free online editions of InTech Books and Journals can be found at www.intechopen.com Part 1 Chapter 1 Part 2 Chapter 2 Part 3 Chapter 3 Part 4 Chapter 4 Chapter 5 Chapter 6 Preface IX Indication for Ventricular Assist Device 1 Indications for Ventricle Assist Devices 3 Guillermo Reyes and Sara Badia Imaging and Ventricular Assist Device 25 Echocardiographic Evaluation of Ventricular Assist Devices 27 David Platts Translational Research and Ventricular Assist Device 47 Altered Expression of mRNA and miRNA during Mechanical Support of the Failing Human Heart 49 Marguérite E.I. Schipper, Sjoukje I. Lok, Hub Dullens, Joyce Van Kuik, Frits H.J. Gmelig-Meyling, Jaap Lahpor, Marc A. Vos, Arnoud Van Der Laarse, Nicolaas De Jonge, Matthijs F.M. Van Oosterhout and Roel A. De Weger Types of Ventricular Assist Device 67 Ventricular Assist Device – How to Obtain Optimal Benefits? 69 Agata Bielecka-Dabrowa, Maciej Banach, Jacek Rysz and Gerry O’Driscoll Cardiac Support and Multiorgan Dysfunction Syndrome 91 Khurram Shahzad, Farhana Latif, Hirokazu Akashi, Tomoko S. Kato, Anshu Sinha, Duygu Onat and Mario C. Deng Future Treatment of Acute Cardiac Collapse - A Role for Percutaneous Circulatory Assist Devices 101 Vepgard Tuseth and Jan Erik Nordrehaug Contents Contents VI Initial Experience of Lower Limb Thermal Therapy for Patients with an Extracorporeal Left Ventricular Assist Device Awaiting Heart Transplantation 125 Kazuo Komamura Complications Following Ventricular Assist Devices 135 Treatment of Ventricular Arrhythmias in Patients Undergoing LVAD Therapy 137 Mulloy, Mahapatra S and Kern JA Ventricular Assist Device-Specific Infections 159 Sunil Pauwaa and Geetha Bhat Management of Venrtricular Assist Device Out-patients 173 Community Based Management of Ventricular Assist Devices 175 Marnie Rodger and Vivek Rao Long Term Outcomes Following Ventricular Assist Device 191 Long-Term Management of Pulsatile Extracorporeal Left Ventricular Assist Device 193 Tomoko Sugiyama Kato, Kazuo Komamura, Noboru Oda, Taro Sasaoka, Ikutaro Nakajima, Ayako Tkakahashi and Masafumi Kitakaze Outcomes Following Heart Transplantation among Those Bridged with VAD 203 Jeffrey H. Shuhaiber Chapter 7 Part 5 Chapter 8 Chapter 9 Part 6 Chapter 10 Part 7 Chapter 11 Chapter 12 Pref ac e Ventricular assist devices are here to stay and will stand the test of time. The imagina- tive frontier is a reality with multiple venues for active clinical, basic and translational research. Clinically applicable assist devices for short-, intermediate- and long-term support have improved signifi cantly in the last ten years. Current devices are down- sizing with enhanced durability and reliability. The associated complication burden including thomboembolism and hemolysis remain a limitation that is not insurmount- able in the near future. Patient selection and technical surgical performance are the key aspects to successful surgical outcome following device insertion. The assist devices will continue adding a large number of years of life to humans globally and empower the medical society to optimize heart failure therapy. While expensive and cumber- some task, the foundation provided in this book refl ects a contemporary product of original research from a multitude of diff erent experts in the fi eld. The book has been organized into parts refl ecting the process by which the caring physician is involved. Part 1 identifi es contemporary indications for device placement, part 2 reviews the role of echocardiographic imaging for ventricular assist device and mycoarium, part 3 identifi es current cellular research prior and following assist device support, part 4 re- views the various types of devices available and their effi cacy both with regard to short term and long term outcomes, part 5 reviews the three major complications following device insertion; infection, stroke and arrythmias, part 6 refl ects some thoughts on managing these patients following hospital discharge and part 7 provides most recent research on patients who had assist device explanted following heart transplantation. We hope this cumulative international eff ort provides the necessary tools for both the novice as well as the active practitioner aiming to change the outcome of these complex patients. Jeff rey H. Shuhaiber Boston, Massachuse s 2011 [...]... characteristics of the different kinds of ventricular assist devices 7.1 Intermediate ventricle assist devices Fig 3 ABIOMED BVS 5000 blood pump 15 Indications for Ventricle Assist Devices Intermediate term devices Indications Thoratec VAD Versions Bridge to transplantation Thoratec Paracorporeal ventricular Assist Device (PVAD) Thoratec Implantable Ventricular Assist Device (IVAD) Bridge to recovery... that the use of a biventricular assist device is important in these patients Indications for Ventricle Assist Devices 11 (Leshnower et al, 2005) This must be taken in consideration in right ventricular heart failure, intractable arrhytmias and in the presence of shock with multisystem organ failure Recently, some authors consider that less invasive percutaneous ventricular assist devices may be helpful... Percutaneously bleeding and acute myocardium limb ischemia are Bridge to definite more common surgical treatment Table 4 Intermediate ventricle assist devices: Indications and characteristics 16 Ventricular Assist Devices 7.3 Long ventricle assists devices Long term devices Indications Novacor device Replacement therapy for patients with heart failure Versions Use Advantages Requires normal native aortic... 17-24 Korfer, R.; El-Banayosy, A & Arusoglu, L (1999) Minami K, Breymann T, Seifert D, et al Temporary pulsatile ventricular assist devices and biventricular assist devices Ann Thorac Surg 68, (1999) 678-83 Leshnower, B.; Gleason, T & O´Hara, M (2006) Safety and Efficacy of Left Ventricular Assist Device Support in Postmyocardial Infarction Cardiogenic Shock Ann Thorac Surg 81 (2006) 1365–71 Levy, D.;... Recover microaxial left ventricular assist device reduces mortality for postcardiotomy failure: A threecenter experience J Thorac Cardiovasc Surg 127, (2004) 812 Slater, JP.; Rose, EA & Levin, HR (1996) Low thromboembolic risk without anticoagulation using advanced-design left ventricular assist devices Ann Thorac Surg 62, (1996) 1321–8 Stevenson, LW (2004) Left Ventricular Assist Devices as Destination... 24 Ventricular Assist Devices Weitkemper, HH.; El-Banayosy, A & Arusoglu, L (2004) Mechanical circulatory support: reality and dreams experience of a single center J Extra Corpor Technol 36(2), (Jun 2004) 169-73 Wilson, SR.; Givertz, MM & Stewart, GC (2009) Ventricular assist devices the challenges of outpatient management J Am Coll Cardiol 54(18), (Oct 2009) 1647-59 Part 2 Imaging and Ventricular Assist. .. implantation of left ventricular assist devices with optimal medical management for patients with end-stage heart failure who require, but do not qualify to receive cardiac transplantation This trial demonstrated that the implantation of left -ventricular assist devices decreased the 1-year mortality by a third (from 75% down to 51%) and the two year survival rate was 29% for left ventricle assist device patients... Nguyen, DQ & Bank, AJ (2000) Left ventricular assist device bridge therapy for acute myocardial infarction Ann Thorac Surg 69, (2000) 1146 –51 Park, SJ.; Tector, A & Piccioni, W (2005) Left ventricular assist devices as destination therapy: A new look at survival J Thorac Cardiovasc Surg 129, (2005) 9-17 Pennington, DG.; Oaks, TE & Lohmann, DP (1999) Permanent ventricular assist device support versus cardiac... Destination therapy with ventricular assist devices Cardiology 101(1-3), (2004) 104-10 Reilly, MP.; Wiegers, SE & Cucchiara, AJ (2000) Frequency, risk factors, and clinical outcomes of left ventricular assist device-associated ventricular thrombus Am J Cardiol 86, (2000) 1156 Reul, H & Akdis, M Temporary or permanent support and replacement of cardiac function Expert Rev Med Devices 1(2), (Nov 2004)... veno-venous hemofiltration and dialysis, should be pursued 18 Ventricular Assist Devices Fig 4 Biventricular assist device Cannula implantation 9 Conclusions Heart transplantation is the gold standard therapy for end stage heart failure disease However, there is a lack of donors and some patients have some kind of contraindications Ventricle assist devices can be used in different clinical situations The . for Ventricular Assist Device 1 Indications for Ventricle Assist Devices 3 Guillermo Reyes and Sara Badia Imaging and Ventricular Assist Device 25 Echocardiographic Evaluation of Ventricular Assist. VENTRICULAR ASSIST DEVICES Edited by Jeff rey H. Shuhaiber Ventricular Assist Devices Edited by Jeffrey H. Shuhaiber Published by InTech Janeza. Komamura Complications Following Ventricular Assist Devices 135 Treatment of Ventricular Arrhythmias in Patients Undergoing LVAD Therapy 137 Mulloy, Mahapatra S and Kern JA Ventricular Assist Device-Specific