Clinically Actionable Prevention and Management of Major Complications During Durable Left Ventricular Assist Device Support: A Contemporary Narrative Review
- 1Department of Cardiovascular Surgery, The First Affiliated Hospital of Wannan Medical University (Yijishan Hospital), Wuhu, Anhui, China
Abstract
Durable left ventricular assist devices (LVADs) have become an established therapy for selected patients with advanced heart failure as bridge-to-transplant or destination therapy. Despite major progress in continuous-flow pump design and perioperative care, long-term benefit remains constrained by a recurrent burden of right heart failure, aortic regurgitation, pump thrombosis, stroke, bleeding, infection, and end-organ dysfunction. Because these events often arise from the interaction of altered hemodynamics, hemocompatibility-related injury, chronic antithrombotic exposure, and the practical complexity of longitudinal device care, a complication-centered management framework is clinically useful. This contemporary narrative review focuses on actionable prevention, surveillance, and treatment strategies for the major complications encountered during durable LVAD support. Rather than providing a broad device-oriented overview, we emphasize clinically relevant decision points across the perioperative and long-term course, including right ventricular protection, antithrombotic balance, structured monitoring for aortic regurgitation and hemolysis, prevention of driveline infection, and multidisciplinary outpatient follow-up. By organizing current evidence around practical management pathways, this review aims to support earlier recognition of adverse events and more durable long-term support.
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BibTeX
@article{sheng2026clinically,
title = {{Clinically Actionable Prevention and Management of Major Complications During Durable Left Ventricular Assist Device Support: A Contemporary Narrative Review}},
author = {Wei Yong Sheng and Tian Sheng Tang and You Shi Wu and Hussain Asif and Saifane Zakaria and Da Fa Zhang},
journal = {Cardiology research},
year = {2026},
month = oct,
doi = {10.14740/cr2283},
url = {https://europepmc.org/article/PMC/PMC13719642},
note = {CC BY},
}
RIS
TY - JOUR
TI - Clinically Actionable Prevention and Management of Major Complications During Durable Left Ventricular Assist Device Support: A Contemporary Narrative Review
AU - Wei Yong Sheng
AU - Tian Sheng Tang
AU - You Shi Wu
AU - Hussain Asif
AU - Saifane Zakaria
AU - Da Fa Zhang
PY - 2026
DA - 2026/10/24
JO - Cardiology research
DO - 10.14740/cr2283
UR - https://europepmc.org/article/PMC/PMC13719642
AB - Durable left ventricular assist devices (LVADs) have become an established therapy for selected patients with advanced heart failure as bridge-to-transplant or destination therapy. Despite major progress in continuous-flow pump design and perioperative care, long-term benefit remains constrained by a recurrent burden of right heart failure, aortic regurgitation, pump thrombosis, stroke, bleeding, infection, and end-organ dysfunction. Because these events often arise from the interaction of altered hemodynamics, hemocompatibility-related injury, chronic antithrombotic exposure, and the practical complexity of longitudinal device care, a complication-centered management framework is clinically useful. This contemporary narrative review focuses on actionable prevention, surveillance, and treatment strategies for the major complications encountered during durable LVAD support. Rather than providing a broad device-oriented overview, we emphasize clinically relevant decision points across the perioperative and long-term course, including right ventricular protection, antithrombotic balance, structured monitoring for aortic regurgitation and hemolysis, prevention of driveline infection, and multidisciplinary outpatient follow-up. By organizing current evidence around practical management pathways, this review aims to support earlier recognition of adverse events and more durable long-term support.
SN - 1923-2829
SN - 1923-2837
ER -