Use of Left Ventricular Assist Devices as Destination Therapy in End-stage Congestive Heart Failure


Book Description

Heart failure is defined as reduced ability of the heart to pump blood and maintain normal bodily function. Heart transplantation is currently the preferred treatment for end-stage heart failure but the supply of donor hearts is insufficient to meet the need and many patients are not eligible for transplantation due to age or comorbid conditions. Implantable mechanical pumps can assist the circulation of blood by the ventricles. Left ventricular assist devices (LVADs) have been approved by the U.S. Food and Drug Administration (FDA) for use in patients awaiting transplant (a bridge to transplant) and as a last resort in patients with refractory heart failure who are not eligible for a heart transplant (destination therapy). In January 2010, the first newer generation, rotary continuous flow ventricular assist device (HeartMate II) was approved by the FDA for destination therapy. Eligibility criteria are essentially the same as those used to select patients for the pivotal clinical trial that included patients with shortness of breath and/or fatigue at rest or during minimal exertion despite treatment with optimal therapy for heart failure associated with a low ejection fraction (




Core Topics in Cardiothoracic Critical Care


Book Description

Most patients with critical cardiac or thoracic conditions will at some stage pass through the cardiothoracic critical care unit. Critical care presents more complex clinical data than any other area of medicine. The new edition of Core Topics in Cardiothoracic Critical Care focuses on the latest practise in the management of patients in cardiothoracic intensive care. The practice of cardiothoracic critical care medicine is constantly evolving, and this new edition reflects the modernized learning styles for trainees. Each chapter includes key learning points as well as sample multiple choice questions and answers to assist in exam preparation. This edition also features updated chapters on ECMO, perioperative management of patients undergoing emergency cardiothoracic surgery, and advanced modes of organ support for patients. This text provides key knowledge in a concise and accessible manner for trainees, clinicians and consultants from specialities and disciplines such as cardiology and anaesthesia, and nursing and physiotherapy.




Rotary Blood Pumps


Book Description

Rotary blood pumps increasingly are being used in open heart surgery and in assisted circulation for patients with heart disease. These rotary devices include vortex (centrifugal) and axial pumps, which can be utilized in conditions where the use of conventional pulsatile pumps would entail problems of cost and size. Rapid progress is now being made in developing new devices for controlling blood flow within the heart and great vessels as well as extracorporeally for use in coronary and intensive care units and, in the future, for long-term use. This book provides information on the physiology of nonpulsatile circulation, the development of rotary pump engineering, and the clinical application of rotary blood pumps. It also presents an overview of future developments in this important field.




The Artificial Heart


Book Description

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.




Mechanical Circulatory Support in End-Stage Heart Failure


Book Description

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.




Congestive Heart Failure and Cardiac Transplantation


Book Description

This book is a comprehensive overview of heart failure and cardiac transplantation and integrates scientific and clinical information about the physiology, pathophysiology, diagnosis, and treatment of this disorder. Organized into five parts, it reviews the history and basic mechanisms of heart failure; etiology of heart failure; heart failure disease progression; advanced therapies for heart failure; and cardiac transplantation. The book presents basic concepts in the physiology, molecular biology, pathology, and epidemiology of the normal and failing heart; known causes of heart failure, such as right heart failure, valvular cardiomyopathy, molecular mechanisms of sarcomeric cardiomyopathies, and neuromuscular cardiomyopathy; cardiorenal syndrome; neurohormonal activation; cardiac resynchronization, ventricular assist devices; regenerative mechanisms; orthotopic heart transplantation; early and late management of the post-transplant patient; heart transplantation and antibody-mediated rejections; heart-lung transplantation; and cardiac xenotransplantation. Featuring contributions from leaders in the fields of heart failure, cardiac transplantation, cardiac pathology, and cardiovascular molecular research, Congestive Heart Failure and Cardiac Transplantation is a valuable compendium for cardiologists, cardiothoracic surgeons, researchers, trainees, and students.




Essential Clinical Anesthesia


Book Description

The clinical practice of anesthesia has undergone many advances in the past few years, making this the perfect time for a new state-of-the-art anesthesia textbook for practitioners and trainees. The goal of this book is to provide a modern, clinically focused textbook giving rapid access to comprehensive, succinct knowledge from experts in the field. All clinical topics of relevance to anesthesiology are organized into 29 sections consisting of more than 180 chapters. The print version contains 166 chapters that cover all of the essential clinical topics, while an additional 17 chapters on subjects of interest to the more advanced practitioner can be freely accessed at www.cambridge.org/vacanti. Newer techniques such as ultrasound nerve blocks, robotic surgery and transesophageal echocardiography are included, and numerous illustrations and tables assist the reader in rapidly assimilating key information. This authoritative text is edited by distinguished Harvard Medical School faculty, with contributors from many of the leading academic anesthesiology departments in the United States and an introduction from Dr S. R. Mallampati. This book is your essential companion when preparing for board review and recertification exams and in your daily clinical practice.




Heart Transplantation


Book Description

Introductory Chapter: Dedicated Initial Giants Breaking the Barriers to Successful Cardiac Transplantation Therapy.




Advanced Concepts in Endocarditis


Book Description

Introductory Chapter: Introduction to Advanced Concepts in Endocarditis.




Oxford Handbook of Cardiac Nursing


Book Description

Fully revised and updated for the second edition, the Oxford Handbook of Cardiac Nursing is the ultimate companion for all those caring for cardiac patients. Systematically covering all the main areas of cardiac nursing, it is packed full of clinical information and practical advice. This new edition now includes expanded information on prevention of cardiovascular disease and heart disease in pregnancy, as well as the latest resuscitation guidelines, protocols, and clinical information. The handbook covers assessment, investigation, treatment, rehabilitation, and pharmacological interventions, and new illustrations and diagrams have been added throughout to aid clarity of information. Although a large part of the handbook focuses on caring for patients with coronary heart disease, many other cardiovascular problems such as valvular heart disease, congenital heart disease, and cardiomyopathies are covered. Designed to be used on the ward, in the community, and for studying and revision, it contains expert guidance, written by experienced nurses and teachers. The book is specifically laid out to enable quick access to precise, targeted information, and covers the vast majority of clinical scenarios. Unique and indispensable, the Oxford Handbook of Cardiac Nursing offers a wealth of information at your fingertips.