Harrison's PodClass: Internal Medicine Cases and Board Prep Ep 121: Patient with Advanced Heart Failure
Oct 10, 2024
Dive into the fascinating world of left ventricular assist devices (LVADs) and their crucial role in managing advanced heart failure. Learn about the evolution of these devices from temporary fixes to long-term life-saving solutions. The discussion covers the criteria for candidacy, associated risks, and the innovative centrifugal flow technology that enhances patient care. Engaging case studies illuminate real-life applications, shedding light on how these advancements are transforming treatment options for patients in need.
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Evolution To Continuous Long-Term Support
- LVAS devices evolved from short-term bridges to frequent long-term destination therapy as technology improved.
- Current continuous-flow LVASs are now the dominant form of mechanical left ventricular support.
Modern Pump Design Reduces Complications
- Modern LVASs use centrifugal, magnetically levitated pumps to reduce thrombosis, hemolysis, and stroke risk.
- These engineering advances improved safety compared with earlier pulsatile devices.
Evidence Supports Survival And QoL Benefit
- Trials like REMATCH and registry data show survival and quality-of-life benefits for LVAS recipients versus medical therapy.
- Median survival with current devices exceeds 50% at four years, though durability beyond 5–10 years is uncertain.
