Role of continuous flow Left ventricular assist device in the management of patients with heart failure

Abstract

Heart failure (HF) often occurs as the terminal common pathway of any combination of cardiac conditions that affect the myocardium‘s productivity. It can be described as the inability of the heart to adequately fill or contract in order to meet the body‘s metabolic demands HF is a clinical syndrome characterized by typical symptoms (e.g. breathlessness, ankle swelling and fatigue) that may be accompanied by signs (e.g. elevated jugular venous pressure, pulmonary crackles and peripheral oedema) caused by a structural and/or functional cardiac abnormality, resulting in a reduced cardiac output and/ or elevated intracardiac pressures at rest or during stress. Worldwide a constant decline of heart transplantations (HTx) is observed. While the numbers of patients awaiting HTx doubled within the last 15 years, available donor organs dropped by a third. In 2015, 790 patients in Germany were listed for HTx with only 286 hearts to be transplanted. A decline in one-year survival after HTx from 85% to 76% in the EuroTransplant region is observed, presumably because of increasing donor age and recipient comorbidity. About 15% of patients listed for transplantation die before an organ is available and more than 30% of patients awaiting HTx need mechanical circulatory support with left ventricular assist devices