RESUMO
Angiotensin receptor-neprilysin inhibitors (ARNIs) greatly benefit functional capacity and longevity in heart failure with reduced ejection fraction (HFrEF). Angiotensin receptor-neprilysin inhibitors remain underutilized and unstudied, however, in left ventricular assist device (LVAD) recipients, in spite of their underlying HFrEF. In this case series, we studied the feasibility and short-term efficacy of ARNI utilization in 21 LVAD patients. Angiotensin receptor-neprilysin inhibitor initiation was successful in most, resulting in significant consolidation of blood pressure (BP) medical management and marked improvements in both functional capacity and diuretic requirements. Angiotensin receptor-neprilysin inhibitors are safe, feasible, and within a short timeframe benefit BP and heart failure control in LVAD recipients.
Assuntos
Insuficiência Cardíaca , Coração Auxiliar , Antagonistas de Receptores de Angiotensina/uso terapêutico , Angiotensinas , Pressão Sanguínea , Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/cirurgia , Coração Auxiliar/efeitos adversos , Humanos , Neprilisina , Receptores de Angiotensina , Volume SistólicoRESUMO
Preventative polytetrafluoroethylene coverings are often used to protect the left ventricular assist device outflow graft during sternal re-entry. We herein describe 5 cases of late-onset, significant left ventricular assist device outflow graft obstruction due to external outflow graft compression. We present clinical presentations, therapies and outcomes.
