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First International VAD Guidelines

Portable pumps support failing hearts (Feb. 1)

With the rapidly growing use of ventricular assist devices (VADs) — surgically implanted, portable pumps that support the failing heart in patients with end-stage heart failure — the International Society for Heart and Lung Transplantation has issued its first guidelines for the selection, implantation, and management of these life-saving devices.

The guidelines appeared in the Feb. 1 issue of the Journal of Heart and Lung Transplantation.

“VADs have led to improved outcomes in patients with fewer complications, while being smaller and more reliable than models developed just a few years ago,” said co-author Jeff Teuteberg, MD. “As more patients are implanted with these devices and supported on them for many years, it’s particularly important to apply evidence-based guidelines to their use.”

VAD implantation can give renewed life to patients with advanced heart failure who are not helped by conventional medical therapy, according to the authors. Each year, approximately 2,000 people in the U.S. receive a VAD, which does not replace the heart, but rather takes the blood from the weakened heart and pumps it to the body and vital organs.

“Until now, there has not been a consensus on how to manage patients supported with these devices. We hope these guidelines will highlight not only what we know, but what we don’t know about mechanical support,” Teuteberg said.

Teuteberg and his colleagues spent more than 18 months reviewing studies and conferring with peers in the medical community as they prepared the guidelines covering patient selection, intra-operative management, and post-operative care.

“VADs are no longer just for short-term therapy,” Teuteberg said. “Because the pumps are better and more patients are living longer with them, there are more chronic medical issues that we have not had to systematically address until the past several years.”

Source: UPMC; February 1, 2013.

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