Recommendations for the Use of Mechanical Circulatory Support: Ambulatory and Community Patient Care: A Scientific Statement from the American Heart Association

Jennifer L. Cook, Monica Colvin, Gary S. Francis, Kathleen L. Grady, Timothy M. Hoffman, Mariell Jessup, Ranjit John, Michael S. Kiernan, Judith E. Mitchell, Francis D. Pagani, Michael Petty, Pasala Ravichandran, Joseph G. Rogers, Marc J. Semigran, Matthew M. Toole, On behalf of the American Heart Association Heart Failure and Transplantation Committee of the Council on Clinical Cardiology; Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation; Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Radiology and Intervention; and Council on Cardiovascular Surgery and Anesthesia

Research output: Contribution to journalArticle

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Abstract

Mechanical circulatory support (MCS) offers a surgical option for advanced heart failure when optimal medical therapy is inadequate. MCS therapy improves prognosis, functional status, and quality of life.1,2 The INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) tracks patient selection and outcomes for all implanted US Food and Drug Administration-approved MCS devices. From June 2006 until December 2014, 15 000 patients received MCS, and 2000 implantations are performed annually. One-year survival with current continuous-flow devices is reported to be 80%, and 2-year survival, 70%.3 In patients awaiting heart transplantation, MCS provides a bridge to transplantation, and for others who are ineligible for heart transplantation, MCS provides permanent support or destination therapy. Indications and absolute and relative contraindications to durable MCS are listed in Table 1.

Original languageEnglish (US)
Pages (from-to)e1145-e1158
JournalCirculation
Volume135
Issue number25
DOIs
StatePublished - Jun 20 2017

Keywords

  • AHA Scientific Statements
  • ambulatory care
  • congestive heart failure
  • emergency care
  • emergency first responders
  • ventricular assist device

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    Cook, J. L., Colvin, M., Francis, G. S., Grady, K. L., Hoffman, T. M., Jessup, M., John, R., Kiernan, M. S., Mitchell, J. E., Pagani, F. D., Petty, M., Ravichandran, P., Rogers, J. G., Semigran, M. J., Toole, M. M., & On behalf of the American Heart Association Heart Failure and Transplantation Committee of the Council on Clinical Cardiology; Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation; Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Radiology and Intervention; and Council on Cardiovascular Surgery and Anesthesia (2017). Recommendations for the Use of Mechanical Circulatory Support: Ambulatory and Community Patient Care: A Scientific Statement from the American Heart Association. Circulation, 135(25), e1145-e1158. https://doi.org/10.1161/CIR.0000000000000507