Multidisciplinary approach for circulatory support in patients with advanced heart failure.
Academic Article
Overview
abstract
Despite the efficacy of heart-failure (HF) therapy, patients may still decompensate and require hospitalization. In addition to the gap between guidelines and clinical practice, this highlights the need for a multidisciplinary approach to the management of HF. The third European Mechanical Circulatory Support Summit presented the latest trials and trends in conservative therapy of end-stage HF (ESHF) and the alternative options over a ten-session program. The meeting covered topics such as epidemiological trends, different HF registries and guidelines for ESHF therapy. In addition to databases and HF trials, the presenters discussed the integration of multiple biomarkers in HF stratification, biological solution and embryonic stem cells for HF therapy, up-to-date myocardial recovery and the surgical aspects of ESHF treatment. Therapeutic options following short-term left ventricular support were discussed, such as: which patients should receive a ventricular assist device (VAD) and when; what the perfect window for implantation of a VAD is; bridge-to-bridge and device selection; VAD-weaning criteria; left ventricular unloading, patient-device matching (short-term device), cardiac transplantation following short-term support. There was a device update, presenting Circulite, Abiomed Impella, Levacor, Levitronix, VentrAssist, Heartmate II, DuraHeart and Heartware. Finally, the International VAD registry, European VAD registry and The International Society for Heart & Lung Transplantation Mechanical Circulatory Device database were also discussed. Herein, a commentary is givenon some of the interesting topics that indicate the importance of the community, the physician and the patient's awareness of HF, the utilization of the updated guidelines and landmark studies and registries, as well as recent evidence-based modalities in the management of ESHF.
