Mechanical Circulatory Support In End Stage Heart Failure

This book is a detailed practical guide to the use of ventricular assist devices and total artificial hearts to provide mechanical circulatory support (MCS) in patients with end-stage heart failure. It explains why MCS may be indicated, which patients require MCS, when and how to implant ventricular assist devices or a total artificial heart, and how to avoid potential complications of MCS. Management throughout the period of care is described, from preimplantation to follow-up, and both typical and atypical cases are discussed. The text features numerous helpful tips and tricks relating to surgical and nonsurgical management and is supported by a wealth of high-quality illustrations that document the preoperative evaluation and implantation techniques. Heart transplantation remains the gold standard for the treatment of patients suffering from end-stage heart failure, but the shortage of donors has led to an increase in the use of MCS. This book will assist all physicians, and especially cardiologists and anesthesiologists, who are involved in the care of these patients.

Offering comprehensive, authoritative coverage of mechanical circulatory support (MCS), this fully revised companion to Braunwald’s Heart Disease provides the clinically relevant information you need to effectively use this therapy to treat and manage end-stage heart failure. New editors and authors – experts in both cardiology and cardiovascular surgery – bring you fully up to date with the newest technology and devices, as well as basic science, clinical applications, adverse event monitoring and management, socioeconomic implications, future directions, and more. Covers all of the newest techniques, including new-generation devices. Discusses the management of common patient problems, highlighting cautions and outcomes, as well as pathophysiology and rationale for treatment. Brings you up to speed with the latest coverage of ventricular assist devices (VAD), extracorporeal membrane oxygenation (ECMO), next-generation centrifugal pumps, and total artificial hearts. Provides a complete clinical perspective of the latest scientific breakthroughs and analysis of the current literature. Includes coverage of the most recent guidelines and protocols, including MCS for pediatric and congenital heart disease; the Interagency Registry of Mechanically Assisted Circulatory Support (INTERMACS) as a tool to track and advance clinical practice; and cellular, molecular, genomic, and functional changes that occur in the failing heart in response to MCS. Presents practical evidence from the registry of thousands of cases to guide cardiologists, cardiovascular surgeons, emergency physicians, primary care physicians, and other team members on the best management course to follow for each particular patient.

This engaging book provides a state-of-the-art introduction to the rapidly evolving field of mechanical circulatory support therapy in the care of patients with advanced heart failure. It is aimed at healthcare teams around the world who are involved in patient care, research, and teaching of advanced heart failure; healthcare professionals in training; and interested lay persons. In particular, this book. ? serves as a comprehensive resource and practice guide on all aspects of mechanical circulatory support therapy, starting with an overview on heart failure management and then continuing with the referral and evaluation, the care before and after mechanical circulatory support implantation, the analysis of outcomes and complications, as well as a description of research and societal perspectives in the field of mechanical circulatory support therapy;. ? is founded on the expertise of Columbia University Medical Center (New York City), which has one of the most renowned heart failure, mechanical circulatory support, and heart transplantation programs in the world;. ? takes a multidisciplinary integrated healthcare team approach, including the perspectives of cardiologists, cardiac surgeons, nurses, coordinators, social workers, psychologists, physical therapists, financial experts, and bioethicists; and. ? provides in a unique way the complementary viewpoints from the expert healthcare team''s as well as the patient''s and family''s perspectives, with patient vignettes interspersed throughout the entire text.

Mechanical Circulatory Support, by Drs. Robert L. Kormos and Leslie W. Miller, provides the clinically relevant information you need to effectively use this therapy to treat and manage end-stage cardiovascular disease. In this Companion to Braunwald’s Heart Disease, the world’s most prominent experts in mechanical circulatory support (MCS) cover basic science, device construction, clinical applications, socioeconomic implications, future directions, and more. Stay on top of hot topics - including innovative devices like continuous flow pumps, next-generation centrifugal pumps, and total artificial hearts; MCS for pediatric and congenital heart disease; cellular, molecular, genomic, and functional changes that occur in the failing heart in response to MCS; and Interagency Registry of Mechanically Assisted Circulatory Support (INTERMACS) as a tool to track and advance clinical practice. Tap into discussions of hot topics in mechanical circulatory support (MCS), including current types of devices and clinical settings for MCS; MCS for pediatric and congenital heart disease; myocardial recovery, regenerative therapy, bleeding and thrombosis with MCS; cellular, molecular, genomic, and functional changes that occur in the failing heart in response to MCS; and Interagency Registry of Mechanically Assisted Circulatory Support (INTERMACS) as a tool to track and advance clinical practice. Get a complete picture of the role of mechanical circulatory support in treatment through coverage of device construction, clinical applications, socioeconomic implications, and future directions. Master the pathophysiology and rationale of treatment with discussions of basic science in addition to clinically-relevant information and current clinical practice guidelines. Apply the expertise of the world’s most prominent leaders in mechanical circulatory support.

After decades of laboratory investigations mechanical circulatory support for the failing heart has entered the clinical arena. Today, a growing number of patients with progressive myocardial failure awaiting cardiac transplantation is successfully bridged to transplantation with ventricular assist devices. The proceedings of the "Mechanical Circulatory Support"-meeting, held in Berlin, October 21-22, 1995, present new aspects of mechanical circulatory support, recent experience with MCS in newborns and children using specially developed small devices, and the results of long-term mechanical assistance. The ability of the myocardium to recover under pressure de-loading and reduced workload is discussed. All these topics open up new perspectives for the use of mechanical circulatory support, not only as a bridge to transplantation, but also as a definitive approach for treating patients with end-stage heart failure. Some of these concepts may even provide real alternatives to heart transplantation, these being sorely needed in light of the severe donor organ shortage. Regulatory as well as ethical aspects of the extended use of mechanical circulatory support systems and new technical developments in the field are discussed by internationally distinguished experts.

Textbook of Transplantation and Mechanical Support for End-Stage Heart and Lung Disease Comprehensive textbook covering all aspects of the care of patients with advanced heart or lung disease Transplantation and Mechanical Support for End-Stage Heart and Lung Disease is the most comprehensive and contemporary textbook available that addresses the medical and surgical treatment options for patients with end-stage heart and lung disease. All facets of these complex and resource-intensive therapies are covered by leading experts — including the basics of transplant immunology, databases, regulatory and ethical aspects of transplantation and conventional and new modalities of donor organ harvest. Transplantation and Mechanical Support for End-Stage Heart and Lung Disease includes further information on topics such as: Historical developments that facilitated heart and lung transplantation; engineering advances in continuous flow technologies Transplant organizations, oversight, structure, process, databases and registries in the thoracic transplants and MCS field Current strategies in immune modulation, desensitization protocols and mechanisms of allograft rejection and tolerance/immunosenescence Detailed descriptions of donor and recipient surgical procedures as well as comprehensive implantation techniques for all available short- and long-term mechanical circulatory support devices, including ECMO Organ allocation and prioritization, donor evaluation, high risk donors, marginal donors, and risk assessment Richly enhanced with summary tables and color illustrations to provide an engaging and supportive learning experience, the book will serve as a highly valuable source of contemporary knowledge for medical students, residents, nurses, perfusionists, physicians and surgeons involved in the care of these desperately ill group of patients. “This comprehensive book covers all aspects of advanced heart and lung failure treatment, including shock, short-term and durable mechanical assistance, as well as transplantation. The in-depth information will be welcome by newcomers in the field as well as seasoned veterans.” —Andreas Zuckermann, M.D Vice-Chair, Department of Cardiac Surgery, Director of Cardiac Transplantation Program, Medical University of Vienna, Vienna General Hospital “This comprehensive tour-de-force compendium covers practical issues of clinical administration, program development, care pathways, ongoing challenges and opportunities in each treatment area as a must go-to reference for guidance in the rapidly evolving fields of mechanical circulatory support and transplantation.” —Mandeep R. Mehra, MBBS, MSc, FRCP Executive Director, Center for Advanced Heart Disease, Brigham and Women’s Hospital, Harvard Medical School “This unique textbook authored by key opinion leaders is a refreshing ???wind of change??? in our field, one that will well serve all professionals involved in the care of end-stage heart and lung patients for many years to come.” —Marcelo Cypel MD, MSc, FACS, FRCSC Surgical Director Ajmera Transplant Centre at UHN , University of Toronto

A significant medical event is expected in 1992: the first human use of a fully implantable, long-term cardiac assist device. This timely volume reviews the artificial heart program-and in particular, the National Institutes of Health's major investment-raising important questions. The volume includes: Consideration of the artificial heart versus heart transplantation and other approaches to treating end-stage heart disease, keeping in mind the different outcomes and costs of these treatments. A look at human issues, including the number of people who may require the artificial heart, patient quality of life, and other ethical and societal questions. Examination of how this technology's use can be targeted most appropriately. Attention to achieving access to this technology for all those who can benefit from it. The committee also offers three mechanisms to aid in allocating research and development funds.

Heart failure is epidemic throughout the world. A growing incidence and prevalence has resulted in a large population of individuals transitioning to advanced stages of the syndrome and requiring uniquely specialised therapies and cardiac transplantation. i The Oxford Textbook of Advanced Heart Failure and Cardiac Transplantationr is a focused and comprehensive work covering this new and rapidly growing cardiovascular subspecialty. Authored by eminent international experts, it is the authoritative text on advanced heart failure and a central resource for clinicians caring for patients with this condition. By covering a range of characteristics, therapeutic challenges and practical aspects of managing patients, this book provides an in-depth source for cardiologists and other related clinicians. A strong focus on the difficult decision making needed to handle advanced heart failure cases, along with specific knowledge of epidemiology, biology and pathophysiology, creates a key tool for optimally managing these complex patients.