1 Ventricular assist devices: developments in asia and global outlook for the next 10 years

The advent of left ventricular assist systems to support patients with advanced-stage heart failure has been a 50 year odyssey, now available broadly to such patients.1 Engineering advances have ushered in an era of small, durable devices that can be fully implanted within the chest. Yet, haemocompatibility related adverse events, which emanate from the interaction between the device and the patient they support are manifest principally in increased stroke rates, de novo device thrombosis requiring replacement and in gastrointestinal bleeding (a peculiar adverse event resulting from the unnatural physiology of continuous flow with low systemic pulse pressure).2 A novel fully magnetically levitated pump, the HeartMate 3 pump has now been introduced which is engineered with wide blood flow pathways (to decrease shear stress and haemolysis) and programmed with an artificial intrinsic pulse. A large study has demonstrated its superiority in ameliorating pump thrombosis, reducing stroke rates and improving medical resource use and cost of care when compared with other devices such as the HeartMate II pump with a mechanical bearing and axial flow pathway.3 However, much needs to be learned, especially within the Asia Pacific region. Questions of genetic diversity in response to anticoagulation targets, predilection towards haemocompatibility complications and outcomes within this distinct population remain less well understood. Estimates of patient need in this region suggest that ...
Source: Heart Asia - Category: Cardiology Authors: Tags: Keynote Lecture Source Type: research