Medical Procedures, Testing and Technology: Ventricular Assist Devices: Management, Outcomes and Complications (PDF)

In this collection, the authors begin by discussing the characteristics of current mechanical circulatory support devices, their documented problems, management strategies for their use, and new devices currently in development. To manage cardiogenic shock, we need to keep in mind three objectives: adequate organ perfusion, unloading of heart chambers, and adjusting body fluid levels. Short-term mechanical circulatory support plays an important role in managing cardiogenic shock when medical management has failed and the patient's condition is deteriorating. In the following chapter, an overview is provided focusing on the developing state of the art of continuous-flow mechanical circulatory support technology available today for clinical use, devices that are being introduced into clinical practice, and some technologies that are in development. With longer duration of pump use and increasing number of devices implanted, medical professionals worldwide are obtaining more knowledge on the unique physiological interactions of mechanical circulatory devices with the patient's body. The goal of the concluding review are to provide the infectious diseases practitioner with a brief introduction to the general anatomy and physiology of an LVAD, pre-implantation infectious disease management guidance, and an understanding of the epidemiology and pathophysiology of LVAD infections. Methods for the diagnosis and characterization of these infections and suggest medical and surgical approaches for management are also addressed.