Left Ventricular Device Emergencies
To view the entire topic, please log in or purchase a subscription.
Emergency Central is a collection of disease, drug, and test information including 5-Minute Emergency Medicine Consult, Davis’s Drug, McGraw-Hill Medical’s Diagnosaurus®, Pocket Guide to Diagnostic Tests, and MEDLINE Journals created for emergency medicine professionals. Explore these free sample topics:
-- The first section of this topic is shown below --
Basics
Description
Left Ventricular Assist Device (LVAD)- Portable mechanical pump support for the patient with heart failure (HF)
- Components
- Inflow cannula from the left ventricle
- Outflow cannula to the aorta
- Pump: Continuous flow
- Axial or centrifugal
- Patient has no palpable pulse due to LVAD continuous blood flow
- Percutaneous driveline: Connects pump to system control
- System controller:
- Regulates motor power and speed
- Performs diagnostic monitoring
- Alarm display
- Stores data for download
- Batteries: Powers system control and pump
- Power base unit: Charges batteries and powers control and pump
- Goals of VAD therapy:
- Bridge to transplantation (BTT): Support cardiac function prior to heart transplant
- Destination therapy (DT): Support cardiac function for the rest of a patient's life
- Bridge to recovery (BTR): Support cardiac function temporarily to give the heart recovery time
Epidemiology
- 23 million patients with HF worldwide
- 5.1 million patients with HF in the U.S.
- Up to 150,000 patients classified with severe HF, with heart transplant being treatment of choice when medical management has failed
- <3,000 heart transplants performed annually in the U.S.
- Annual mortality rate for patient awaiting heart transplant has dropped continuously from 17% in 2001 due to LVAD as BTT
Etiology
Common LVAD-associated emergencies- Anemia (0.5–18% of patients)
- Acquired von Willebrand disease type 2A due to shear stress on red blood cells
- Anticoagulation
- Bleeding
- Intracranial hemorrhage (ICH) (11%)
- Gastrointestinal (22–40%)
- Arteriovenous malformations (AVMs)
- Angiodysplasias
- Hematuria
- Epistaxis
- Infection (30–50% of patients)
- Driveline: Most common (17–30%)
- Pump pocket (2–10%)
- Cannula or device (0.6%)
- Bloodstream (20–27%)
- Thrombosis (35%)
- Pump thrombosis can result in pump/device failure
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Basics
Description
Left Ventricular Assist Device (LVAD)- Portable mechanical pump support for the patient with heart failure (HF)
- Components
- Inflow cannula from the left ventricle
- Outflow cannula to the aorta
- Pump: Continuous flow
- Axial or centrifugal
- Patient has no palpable pulse due to LVAD continuous blood flow
- Percutaneous driveline: Connects pump to system control
- System controller:
- Regulates motor power and speed
- Performs diagnostic monitoring
- Alarm display
- Stores data for download
- Batteries: Powers system control and pump
- Power base unit: Charges batteries and powers control and pump
- Goals of VAD therapy:
- Bridge to transplantation (BTT): Support cardiac function prior to heart transplant
- Destination therapy (DT): Support cardiac function for the rest of a patient's life
- Bridge to recovery (BTR): Support cardiac function temporarily to give the heart recovery time
Epidemiology
- 23 million patients with HF worldwide
- 5.1 million patients with HF in the U.S.
- Up to 150,000 patients classified with severe HF, with heart transplant being treatment of choice when medical management has failed
- <3,000 heart transplants performed annually in the U.S.
- Annual mortality rate for patient awaiting heart transplant has dropped continuously from 17% in 2001 due to LVAD as BTT
Etiology
Common LVAD-associated emergencies- Anemia (0.5–18% of patients)
- Acquired von Willebrand disease type 2A due to shear stress on red blood cells
- Anticoagulation
- Bleeding
- Intracranial hemorrhage (ICH) (11%)
- Gastrointestinal (22–40%)
- Arteriovenous malformations (AVMs)
- Angiodysplasias
- Hematuria
- Epistaxis
- Infection (30–50% of patients)
- Driveline: Most common (17–30%)
- Pump pocket (2–10%)
- Cannula or device (0.6%)
- Bloodstream (20–27%)
- Thrombosis (35%)
- Pump thrombosis can result in pump/device failure
There's more to see -- the rest of this topic is available only to subscribers.