Troubleshooting left ventricular assist devices: modern technology and its limitations

Abstract

Purpose of review: As the incidence of heart failure continues to rise, modern generation left ventricular assist devices (LVADs) have become the primary therapeutic modality used as both bridge to transplant (BTT) and destination therapy (DT) in patients with acute and chronic heart failure. This review aims to highlight the progression of LVAD technology, outline LVAD complications and manifestations, and provide evidence-based therapeutic methods to troubleshoot such adverse events.

Recent findings: Despite modern innovation, LVAD adverse events continue to hinder the progress of HF paradigms and are associated with a rise in morbidity and mortality. Complications such as bleeding, pump thrombosis, right heart failure, infections, stroke, valvular insufficiency, and arrhythmias are among the most described.

Summary: While the management of LVAD complications is described, standardized guidelines are needed to properly identify and troubleshoot all the complications faced by this patient population to decrease morbidity and mortality further.