Permanent implantable cardiac support systems

In Germany, almost 1000 permanent ventricular assist devices (VADs) are implanted each year in patients with severe heart failure. VADs are miniaturized centrifugal pumps that produce continuous blood flow and are controlled and powered by a cable that passes through the skin. Paracorporal systems are rarely used, especially in children.
The optimal time for VAD implantation cannot be clearly determined. A comparative assessment of the systems is hardly possible because there are no randomized studies available. Register data show a one-year survival after VAD implantation of 69-81%, which is significantly higher than the natural course of severe heart failure. Possible serious complications are infection, right heart failure, bleeding, pump thrombosis, stroke or death.
The implantation of a VAD system can be performed as an alternative to heart transplantation or as a bridge to listing and transplantation. The shortage of organs in Germany means that only a minority of VAD patients are transplanted.
Author(s)Source
Gummert JF, Haverich A, Schmitto JD, Potapov E, Schramm R, Falk VDtsch Arztebl Int 2019; 116: 843–8. DOI: 10.3238/arztebl.2019.0843 (german)
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