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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 27, No 4, July/August 2016
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AFRICA
structural and functional abnormalities, such as ventricular
dysfunction, valvular pathology, mural thrombosis, and atrial
septal defect or patent foramen ovale. The pocket is made deep
and lateral to allow the pump to be fixed below the diaphragm.
The outflow cannula is placed to the right of the sternal midline
with enough graft length to avoid any compression of the RV.
The management of bleeding is indivisibly linked to the risk
of thromboembolic events, and anticoagulation and antiplatelet
therapies seem to be the only methods for carefully managing
complication and individual risks. Further understanding of the
mechanisms underlying bleeding and novel strategies, such as
new anticoagulant drugs, are expected to play crucial roles in the
long-term management of cf-LVAD therapy.
1
Cardiac arrhythmia, such as ventricular arrhythmia, is also
a common issue in the early and late periods after cf-LVAD
implantation. Although such arrhythmias may not be lethal in
the presence of cf-LVAD, it could put patients at a risk of RVF.
1
Anti-arrhythmic medication, catheter ablation, intra-operative
cryoablation, and implantable cardioverter–defibrillator may be
employed to minimise the risk of recurrent arrhythmias.
1
End-organ function was restored one month after the
initiation of support.
1
These improvements persisted throughout
the support period; for example, the LV diastolic dimension
significantly decreased and the TR ratio reduced from 45 to 22%
at one month, except for the creatinine level.
1
Conclusion
The implantation of cf-LVAD, either as BTT or DT, remains a
critical treatment option for selected patients with end-stage HF.
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