- 1 A Historical Perspective on the Development of Mechanical Circulatory Support Devices
- 2 Indications for Mechanical Circulatory Support
- 3 Frailty: Assessment and Associations with Outcomes
- 4 Palliative Care in Mechanical Circulatory Support
- 5 Psychosocial Assessment of Patients Considered for Mechanical Circulatory Support
- 6 Left Ventricular Assist Device Backup for Conventional Surgery
- 7 Preoperative Strategies for Optimizing Mechanical Circulatory Support
- 8 Mechanical Circulatory Support in Patients with Pulmonary Hypertension
- 9 Selecting Children for Mechanical Circulatory Support
- 10 Device Selection for Short- and Long-Term Mechanical Circulatory Support
- 11 The HeartMate II™ Continuous-Flow Left Ventricular Assist System
- 12 The Abbott HeartMate 3™ Left Ventricular Assist System
- 13 The HeartWare<sup>™</sup> HVAD<sup>™</sup> Left Ventricular Assist Device
- 14 The Medtronic Miniature Left Ventricular Assist Device (MVAD)<sup>™</sup> System
- 15 The ReliantHeart aVAD<sup>©</sup>
- 16 The Syncardia Total Artificial Heart
- 17 Counterpulsation Circulatory Assist Devices
- 18 Abiomed Impella Platform
- 19 The Tandem: Life System
- 20 The Abbott CentriMag™ Acute Circulatory Support System and the HeartMate Percutaneous Heart Pump™
- 21 Extracorporeal Membrane Oxygenation
- 22 The Berlin Heart Ventricular Assist Devices
- 23 EVAHEART<sup>®</sup> 2 Left Ventricular Assist Device System
- 24 Anesthesia
- 25 Perfusion Considerations
- 26 Echocardiography in Left Ventricular Assist Device Recipients
- 27 Implantation of Continuous-Flow Left Ventricular Assist Devices via Sternotomy Technical Considerations
- 28 The Less-Invasive (Lateral) Approach to Left Ventricular Device Implantation
- 29 Concomitant Cardiac Valve Procedures with Circulatory Support Device Implantation
- 30 Providing Mechanical Support to Children Size and Anatomical Considerations
- 31 Postoperative Management after Assist Device Implantation
- 32 Anticoagulation Strategies for Patients on Mechanical Circulation Support
- 33 Acquired von Willebrand Syndrome with Mechanical Circulatory Support
- 34 Gastrointestinal Bleeding in Patients with Left Ventricular Assist Devices
- 35 Pump Thrombosis
- 36 Infectious Complications of Mechanical Circulatory Support
- 37 Cerebral Blood Flow and Stroke in Patients with Left Ventricular Assist Devices
- 38 Right Heart Dysfunction
- 39 Renal Failure and Mechanical Circulatory Support Devices
- 40 Arrhythmia/Ventricular Tachycardia Ablation
- 41 Aortic Regurgitation in Patients with Left Ventricular Assist Devices
- 42 Modalities of Left Ventricular Assist Device Optimization
- 43 The CardioMEMS Heart Failure Monitoring System
- 44 Mechanical Circulatory Support as a Bridge to Recovery
- 45 Cardiac and Physical Rehabilitation
- 46 The VAD Coordinator Roles and Responsibilities in Caring for Patients with Ventricular Assist Devices
(p. 345) Modalities of Left Ventricular Assist Device Optimization
- Chapter:
- (p. 345) Modalities of Left Ventricular Assist Device Optimization
- Author(s):
Nikhil Narang
, Gabriel Sayer
, and Nir Uriel
- DOI:
- 10.1093/med/9780190909291.003.0042
Continuous flow left ventricular assist devices (LVADs) are a viable long-term option to the end-stage heart failure patient, with improvements in hemocompatibility seen with newer generation devices. The complex interplay of native myocardial contractility, state of the right ventricle, and presence of aortic insufficiency, among other factors, governs cardiac performance in addition to that from the pump. Deliberate speed adjustments by non-invasive and invasive methods can improve the LVAD hemodynamic profile in a manner tailored to the individual patient. Individualized adjustments in pump parameters by these methods may reduce the longitudinal burden of LVAD-related adverse events.
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- 1 A Historical Perspective on the Development of Mechanical Circulatory Support Devices
- 2 Indications for Mechanical Circulatory Support
- 3 Frailty: Assessment and Associations with Outcomes
- 4 Palliative Care in Mechanical Circulatory Support
- 5 Psychosocial Assessment of Patients Considered for Mechanical Circulatory Support
- 6 Left Ventricular Assist Device Backup for Conventional Surgery
- 7 Preoperative Strategies for Optimizing Mechanical Circulatory Support
- 8 Mechanical Circulatory Support in Patients with Pulmonary Hypertension
- 9 Selecting Children for Mechanical Circulatory Support
- 10 Device Selection for Short- and Long-Term Mechanical Circulatory Support
- 11 The HeartMate II™ Continuous-Flow Left Ventricular Assist System
- 12 The Abbott HeartMate 3™ Left Ventricular Assist System
- 13 The HeartWare<sup>™</sup> HVAD<sup>™</sup> Left Ventricular Assist Device
- 14 The Medtronic Miniature Left Ventricular Assist Device (MVAD)<sup>™</sup> System
- 15 The ReliantHeart aVAD<sup>©</sup>
- 16 The Syncardia Total Artificial Heart
- 17 Counterpulsation Circulatory Assist Devices
- 18 Abiomed Impella Platform
- 19 The Tandem: Life System
- 20 The Abbott CentriMag™ Acute Circulatory Support System and the HeartMate Percutaneous Heart Pump™
- 21 Extracorporeal Membrane Oxygenation
- 22 The Berlin Heart Ventricular Assist Devices
- 23 EVAHEART<sup>®</sup> 2 Left Ventricular Assist Device System
- 24 Anesthesia
- 25 Perfusion Considerations
- 26 Echocardiography in Left Ventricular Assist Device Recipients
- 27 Implantation of Continuous-Flow Left Ventricular Assist Devices via Sternotomy Technical Considerations
- 28 The Less-Invasive (Lateral) Approach to Left Ventricular Device Implantation
- 29 Concomitant Cardiac Valve Procedures with Circulatory Support Device Implantation
- 30 Providing Mechanical Support to Children Size and Anatomical Considerations
- 31 Postoperative Management after Assist Device Implantation
- 32 Anticoagulation Strategies for Patients on Mechanical Circulation Support
- 33 Acquired von Willebrand Syndrome with Mechanical Circulatory Support
- 34 Gastrointestinal Bleeding in Patients with Left Ventricular Assist Devices
- 35 Pump Thrombosis
- 36 Infectious Complications of Mechanical Circulatory Support
- 37 Cerebral Blood Flow and Stroke in Patients with Left Ventricular Assist Devices
- 38 Right Heart Dysfunction
- 39 Renal Failure and Mechanical Circulatory Support Devices
- 40 Arrhythmia/Ventricular Tachycardia Ablation
- 41 Aortic Regurgitation in Patients with Left Ventricular Assist Devices
- 42 Modalities of Left Ventricular Assist Device Optimization
- 43 The CardioMEMS Heart Failure Monitoring System
- 44 Mechanical Circulatory Support as a Bridge to Recovery
- 45 Cardiac and Physical Rehabilitation
- 46 The VAD Coordinator Roles and Responsibilities in Caring for Patients with Ventricular Assist Devices