Therapy Management of VADs

Cardiovascular disease is the leading cause of global morbidity. Chronic ischemic heart disease, acute heart failure, and myocardial infarction are among the primary causes of mortality in Europe (45% of all deaths), the United States of America (34.3%), and worldwide (45% of noncommunicable diseases). Different strategies can be planned for the treatment of heart disease according to the severity, cause, and course of heart failure. It includes adjusting patients’ lifestyle, medication, and surgical treatment. But for patients with end-stage heart failure waiting for heart transplantation, the number of donated hearts is usually insufficient. Therefore, the auxiliary equipment of ventricular implantation becomes very important. Because it can provide different treatment options for patients with heart failure from excessive to recovery, decision, transplantation, or ultimate treatment. According to the seventh INTERMACS data showed that more than 13,000 patients received left ventricular support from the United States in 2014, of which 955 received pulsatile flow LVADs and 12,030 continuous flow LVADs. This chapter provides an overview of the current implantable rotating left ventricular assist device (LVAD), patient selection, surgical overview, and postoperative management strategies.