TDNet Discover

Background: One of the biggest killers facing the United States today is heart disease and heart failure. Since 1969, doctors have been continuing to work on Left Ventricular Assist Devices (LVAD). The first device was developed as a pulsatile model, allowing the blood to continue to flow through the body with a mechanism modeled after the heart’s own pumping system. As time progressed, doctors and engineers continued to advance in the development of LVAD and improve their mechanism by switching to a continuous-flow model. As research continues, and LVAD are always improving, we set out to determine the long-term effects on patients who received continuous-flow LVAD and pulsatile-flow LVAD. Methods: The researchers in this review searched for articles from three databases, EBSCO-medline, PubMed, and EBSCO-CINAHL. The search was completed utilizing the agreed-upon search terms and was completed in duplicate. Specific inclusion and exclusion criteria were used for article selection, along with in duplicate full text review. The National Heart, Lung, and Blood Institute quality assessment tool was utilized to qualitatively analyze the included studies. The level of evidence was determined on each of the articles. Finally, a data extraction tool was utilized to determine the information provided from each of the articles. Results: A total of six studies met the criteria to be included in this review. A total of 2,252 people were included in these studies with the minimum number of participants in a study being 27 and the largest number of participants in a study being 1,287. Four studies indicated that the use of a continuous-flow LVAD resulted in a better outcome for patients. One study found an equal survival for patients who received either a continuous or pulsatile-flow LVAD. One study determined that a pulsatile-flow LVAD was preferable due to the effect the LVAD has on myocardial remodeling. Conclusion: Providers should continue to recommend the use of a continuous-flow LVAD in comparison to pulsatile-flow LVAD at this time. Due to the lack of advancements in the technology used in pulsatile LVAD, further studies will need to be conducted in order to compare the two models accurately.