About-Cardio
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We provide our users the most up-to-date and accurate information on the treatment and prevention of cardio pathologies in accordance with current American and European clinical guidelines.
The information provided on this website is for educational purposes only and should not be considered medical advice. Always consult a licensed physician for diagnosis and treatment.
TandemHeart: A Percutaneous Ventricular Assist Device (pVAD)
Introduction
TandemHeart is a type of percutaneous ventricular assist device (pVAD) used to provide short-term mechanical circulatory support in patients with severe heart failure or cardiogenic shock. It is particularly useful when traditional medical management is insufficient.
How Does TandemHeart Work?
Key Features:
- Percutaneous insertion: Unlike surgical ventricular assist devices (VADs), TandemHeart can be implanted via catheterization, avoiding open-heart surgery.
- Left atrial-to-femoral artery bypass: It withdraws oxygenated blood from the left atrium and pumps it into the femoral artery, bypassing the failing ventricle.
- Improved cardiac output: It can provide a significant increase in cardiac output (up to 5 L/min), stabilizing organ perfusion in critical patients.
- Short-term use: It is designed for temporary support, typically a few days, until further therapeutic decisions (e.g., heart transplant, durable VAD, or recovery).
Clinical Applications
Indications:
- Cardiogenic shock due to acute myocardial infarction (AMI)
- Decompensated heart failure
- High-risk percutaneous coronary interventions (PCI)
- Bridge to longer-term mechanical support or transplant
Contraindications:
- Severe peripheral vascular disease (blocks femoral artery access)
- Aortic regurgitation (as blood might pump backward)
- Left atrial thrombus (risk of embolization)
Benefits and Risks
Benefits:
- Rapid deployment and stabilization
- Avoids the complexity of surgical VAD implantation
- Provides better unloading of the left ventricle compared to intra-aortic balloon pumps (IABP)
Risks:
- Vascular complications (e.g., limb ischemia, bleeding)
- Hemolysis (destruction of red blood cells)
- Infection
- Risk of thromboembolism
Conclusion
TandemHeart is an effective short-term mechanical circulatory support device that offers a bridge to recovery or more long-term solutions in critically ill patients. However, its usage should be carefully considered based on patient suitability and potential complications.
Source recommendations
1. American Heart Association Guidelines for Cardiogenic Shock
- https://www.ahajournals.org/doi/10.1161/JAHA.119.011991
- https://www.heart.org/en/professional/quality-improvement/cardiogenic-shock-registry
- https://www.ahajournals.org/doi/10.1161/cir.0000000000000525
- https://www.jacc.org/doi/10.1016/j.jacc.2021.12.012
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000001309
2. European Society of Cardiology Guidelines on Acute Heart Failure
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Acute-and-Chronic-Heart-Failure
- https://academic.oup.com/eurheartj/article/42/36/3599/6358045
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Focused-Update-on-Heart-Failure-Guidelines
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000001063
- https://pubmed.ncbi.nlm.nih.gov/34447992/
3. American College of Cardiology Consensus on Mechanical Circulatory Support
- https://pubmed.ncbi.nlm.nih.gov/25861963/
- https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2015/04/07/12/51/2015-expert-consensus-on-percutaneous-mechanical-circulatory-support
- https://scai.org/publications/clinical-documents/scaiacchfsasts-clinical-expert-consensus-statement-use-percutaneous
- https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2022/03/15/21/55/2022-ACC-Expert-Consensus-on-CV-Sequelae-of-COVID
- https://www.jacc.org/doi/10.1016/j.jacc.2015.02.043
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If you or your loved ones experience any of these symptoms, you should consult a doctor in time. Remember that self-medication can be dangerous, and timely diagnosis will preserve the quality and life expectancy.
The heart is an organ that does not know how to "keep silent" if something goes wrong. Chest pain, shortness of breath, swelling, dizziness, and rhythm disturbances are the symptoms that require our attention. The best prevention of heart disease is careful attention to your health, regular checkups with a doctor, and a healthy lifestyle. Take care of your heart, and it will serve you for many years!
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We monitor all innovations and changes in the field of cardiac disease treatment on a daily basis.
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Every 3-5 years, half of the scientific approaches to treatment in the field of cardiology are reviewed as a result of specialized scientific discoveries. With us, you don't have to wait these years to learn about the best ways to treat you and your loved ones.