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Mechanical support of the circulation 

Mechanical support of the circulation
Mechanical support of the circulation

Vladimir Saplacan

, Mario Gaudino

, and Massimo Massetti

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date: 28 September 2020

Mechanical heart support is part of the possible interventions to treat a drug-refractory heart failure. This conditions may be relatively often faced in cardiac surgery, which is the typical environment for the implantation of mechanical heart support systems. This chapter starts with a description of the possible goals related to the implant of a mechanical support system: bridge to recovery, bridge to transplant, destination therapy. Patient selection criteria are carefully addressed. Subsequently, the different devices nowadays available are described, based on their mechanical characteristics and the expected duration of the support: short- and long-term devices; continuous and pulsatile flow; paracorporeal; and totally implantable systems. Finally, the main complications following a mechanical support system implantation are described: including bleeding, thromboembolic complications, infections, and failure of the device.

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