See related article, p 2702. In the past 50 years, we have learnt to transition mechanical circulatory support devices, such as durable left ventricular assist systems (LVAS), from crisis intervention life-saving devices to the contemporary era of using such therapy in prolonging meaningful life in patients with advanced heart failure. Despite generational shifts in engineering of such devices,...

The number of patients with advanced heart failure that has become unresponsive to conventional medical therapy is increasing rapidly. One of the most promising new alternatives to heart transplantation is use of ventricular assist devices (VADs). To date, there are no guidelines for appropriate selection for use of these devices that are approved by national societies in the field. This review...

Heart failure affects more than 5 million people in the United States. The treatments of this disease include medical therapy, heart transplantation, and the implantation of ventricular assist devices. These devices are used in patients who are no longer responsive to conservative medical treatment, who are not candidates for a heart transplantation (destination therapy), who are awaiting a hea...

Alternative CPR Techniques Alternative techniques to standard manual CPR have been developed to improve perfusion during CPR. These include interposed abdominal compression (IAC) CPR, highfrequency CPR, active compression-decompression (ACD) CPR, vest CPR, mechanical (piston) CPR, simultaneous ventilation-compression (SVC) CPR, phased thoracicabdominal compression-decompression (PTACD) CPR, and...

Clinical Challenge What can we offer a 70-year-old retired schoolteacher hospitalized with congestion for the third time in 6 months? The LVEF is 21%. Shortness of breath interrupts sleeping and dressing, and peak oxygen consumption of 9 mL/kg per minute confirms NYHA Class IV status. He has noninsulindependent diabetes and chronic coronary artery disease, with patent grafts to thin-caliber ves...

During the last 20 years, the management of heart failure has significantly improved by means of new pharmacotherapies, more timely invasive treatments and device assisted therapies. Indeed, advances in mechanical support, namely with the development of more efficient left ventricular assist devices (LVAD), and the total artificial heart have reduced mortality and morbidity in patients with end...

In this paper, an integrated model of the human circulatory system with a brushless DC axial flow ventricular assist device (VAD) was developed. The resulting nonlinear hybrid model is then used to design the VAD feedback control system. The VAD controller is designed to maintain a physiologically motivated perfusion; it is tested using computer simulations of different scenarios ranging from t...

Alternative CPR Techniques Alternative techniques to standard manual CPR have been developed to improve perfusion during CPR. These include interposed abdominal compression (IAC) CPR, highfrequency CPR, active compression-decompression (ACD) CPR, vest CPR, mechanical (piston) CPR, simultaneous ventilation-compression (SVC) CPR, phased thoracicabdominal compression-decompression (PTACD) CPR, and...

Alternative CPR Techniques Alternative techniques to standard manual CPR have been developed to improve perfusion during CPR. These include interposed abdominal compression (IAC) CPR, highfrequency CPR, active compression-decompression (ACD) CPR, vest CPR, mechanical (piston) CPR, simultaneous ventilation-compression (SVC) CPR, phased thoracicabdominal compression-decompression (PTACD) CPR, and...

The use of ventricular assist devices has expanded significantly since their approval by the Food and Drug Administration in the United States in 1994. In addition to this, the prevalence of heart failure continues to increase. We aim to provide an overview of perioperative considerations and management of these patients for non-cardiac surgery. We performed a Medline search for the words "vent...