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J Thorac Cardiovasc Surg 2009;138:9-10
© 2009 The American Association for Thoracic Surgery

Editorial

Man and machine: Understanding the complex physiologic interactions to reduce complications

Nicholas G. Smedira, MD*

Department of Thoracic/Cardiovascular Surgery, The Cleveland Clinic, Cleveland, Ohio

Received for publication March 9, 2009; accepted for publication March 29, 2009.

* Address for reprints: Nicholas G. Smedira, MD, The Cleveland Clinic Foundation, Department of Thoracic/Cardiovascular Surgery, 9500 Euclid Avenue, Desk F25, Cleveland, OH 44195. (Email: smedirn@ccf.org).

The first 20% of the full text of this article appears below.

Lietz and colleagues1Go examined neurologic dysfunction after placement of left ventricular assist device (LVAD), an important and timely topic. Almost as important is the fact that the LVAD examined, the HeartMate XVE (Thoratec, Pleasanton, Calif), a first-generation displacement pump, will soon be of historical interest only with the successful use of continuous flow pumps. The value of this work as I saw it was to heighten our awareness of how limited our understanding of cerebral and organ perfusion during mechanical support is—whether it be too much, too little, or the wrong type—and to encourage us to intensify our investigations into understanding this in an effort to improve patient management and reduce complications.

Since the approval of the HeartMate II for bridge to transplantation in April 2008 and the use in clinical trials of third-generation centrifugal pumps such as the Duraheart (Terumo Heart, Ann Arbor, Mich), Heartware (Heartware International, Framingham, Mass), and VentrAssist (Ventracor, Foster City, Calif) pumps, continuous flow pumps have become the devices of choice at almost all major institutions, and rightfully so. . . . [Full Text of this Article]


Related Article

The role of cerebral hyperperfusion in postoperative neurologic dysfunction after left ventricular assist device implantation for end-stage heart failure
Katherine Lietz, Kevin Brown, Syed S. Ali, Monica Colvin-Adams, Andrew J. Boyle, David Anderson, Alan D. Weinberg, Leslie W. Miller, Soon Park, Ranjit John, and Ronald M. Lazar
J. Thorac. Cardiovasc. Surg. 2009 137: 1012-1019. [Abstract] [Full Text] [PDF]





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