Mechanical Circulatory Support for Advanced Heart Failure

Jeffrey A. Morgan, MDChief, Division of Cardiothoracic TransplantationSurgical Director, Advanced Heart Failure CenterCHI Baylor St. Luke's Medical CenterTexas Heart Institute6770 Bertner Avenue, Suite C-355NHouston, TX 77030

Andrew Civitello, MDMedical Director, Heart Transplant ProgramCo-Director, Advanced Heart Failure CenterCHI Baylor St. Luke's Medical CenterTexas Heart Institute6620 Main Street, Suite 1225Houston, TX 77030

O.H. Frazier, MDChief, Center for Cardiac SupportCHI Baylor St. Luke's Medical CenterTexas Heart InstitutePO Box 20345, MC 2-114AHouston, TX 77225

This book provides the most up to date information on every aspect of clinical care relating to patients with advanced heart failure who require mechanical circulatory support as a treatment strategy. The book begins with an extensive description of the preoperative patient selection process as well as preoperative medical optimization, including bridge to bridge strategies with short-term devices. The book then transitions into a description of a variety of surgical implantation techniques with special considerations for reoperative surgery. A chapter on intraoperative anesthesia management is specifically focused on intraoperative issues relating to MCS patients. Subsequent chapters focus on perioperative management as well as long-term management of patients on MCS, including optimization of a patient's LVAD speed. A dedicated chapter on the diagnosis of device thrombosis as well as surgical techniques and outcomes associated with device exchanges is also included. The book also summarizes the national and international outcomes data for using MCS as a bridge to transplant and destination therapy. There is also a chapter on the utility of stem cells as an adjunct technique for inducing myocardial recovery. Finally, the book has chapters on complications of MCS, management of right ventricular failure, and the future of MCS.

Provides the most up to date information on every aspect of clinical care relating to patients with advanced heart failure who require mechanical circulatory supportWritten by experts in the field from the Texas Heart InstituteSummarizes the national and international outcomes data for using MCS as a bridge to transplant and destination therapy

History of Mechanical Circulatory Support.- Who is an Appropriate Candidate for Long-Term MCS: The Art of Patient Selection.- Optimization of Right Ventricular Function Pre-Operatively for LVAD Implantation.- Bridge-to-Bridge Strategies with IABP, Impella, and Tandem Heart.- LVAD Surgical Implant Technique: Extra-Peritoneal Approach.- LVAD Surgical Implant Technique: Infra-Diaphragmatic Approach.- Intraoperative Anesthesia Management.- Perioperative Management of LVAD Patients.- Perioperative Optimization of a Patient's Fluid Status.- Chronic Management of Patients with Left Ventricular Assist Devices.- Surveillance Echocardiography for LVAD Patients.- Diagnosis of Device Thrombosis.- Device Exchange: THI Technique Involving a Left Subcostal Approach.- Mechanical Circulatory Support to Bridge to a Long-term Continuous-flow Left Ventricular Assist Device as a Bridge to Heart Transplantation.- Outcomes Using LVADs for Destination Therapy.- Cardiac Regenerative Strategies for Advanced Heart Failure.- Long-Term Complications of Ventricular Assist Devices.- Right Ventricular Failure in Patients Undergoing LVAD Placement.