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2019 EACTS Expert Consensus on long-term mechanical circulatory support

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  • Evgenij V Potapov
  • Christiaan Antonides
  • Maria G Crespo-Leiro
  • Alain Combes
  • Gloria Färber
  • Margaret M Hannan
  • Marian Kukucka
  • Nicolaas de Jonge
  • Antonio Loforte
  • Lars H Lund
  • Paul Mohacsi
  • Michiel Morshuis
  • Ivan Netuka
  • Mustafa Özbaran
  • Federico Pappalardo
  • Anna Mara Scandroglio
  • Martin Schweiger
  • Steven Tsui
  • Daniel Zimpfer
  • Finn Gustafsson
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Long-term mechanical circulatory support (LT-MCS) is an important treatment modality for patients with severe heart failure. Different devices are available, and many-sometimes contradictory-observations regarding patient selection, surgical techniques, perioperative management and follow-up have been published. With the growing expertise in this field, the European Association for Cardio-Thoracic Surgery (EACTS) recognized a need for a structured multidisciplinary consensus about the approach to patients with LT-MCS. However, the evidence published so far is insufficient to allow for generation of meaningful guidelines complying with EACTS requirements. Instead, the EACTS presents an expert opinion in the LT-MCS field. This expert opinion addresses patient evaluation and preoperative optimization as well as management of cardiac and non-cardiac comorbidities. Further, extensive operative implantation techniques are summarized and evaluated by leading experts, depending on both patient characteristics and device selection. The faculty recognized that postoperative management is multidisciplinary and includes aspects of intensive care unit stay, rehabilitation, ambulatory care, myocardial recovery and end-of-life care and mirrored this fact in this paper. Additionally, the opinions of experts on diagnosis and management of adverse events including bleeding, cerebrovascular accidents and device malfunction are presented. In this expert consensus, the evidence for the complete management from patient selection to end-of-life care is carefully reviewed with the aim of guiding clinicians in optimizing management of patients considered for or supported by an LT-MCS device.

Original languageEnglish
JournalEuropean journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
Issue number2
Pages (from-to)230-270
Number of pages41
Publication statusPublished - 1 Aug 2019

    Research areas

  • Expert consensus, Heart failure, Left ventricular assist devices, Mechanical circulatory support

ID: 57664594