Reviewing the clinical utility of ventricular assist device log files
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REVIEW ARTICLE
Reviewing the clinical utility of ventricular assist device log files Sam Emmanuel 1,2,3
&
Jared Engelman 2 & Christopher Simon Hayward 1,2,4
Received: 7 August 2019 / Revised: 11 October 2019 / Accepted: 14 October 2019 # Indian Association of Cardiovascular-Thoracic Surgeons 2020
Abstract Background Ventricular assist devices (VADs) have provided a temporising solution to many individuals with refractory heart failure (HF) while awaiting a suitable donor for heart transplantation which remains the gold standard in treatment. Many of the discussions around VADs involve ongoing morbidity; however, one aspect of VADs that is often overlooked is the utility of their log files. We decided to review the literature for mentions of the clinical utility of VAD log files. Methods A keyword search was utilised on PUBMED using the terms ‘Ventricular Assist Device’ and ‘Log files’. Perhaps unsurprisingly, this search only yielded 4 results with further articles being discovered through the bibliography of these publications. Results The 4 identified articles provided basic information on log files, particularly with reference to the HVAD. Logs can be categorised into three types—data (pump parameters), events (changes in parameters) and alarms (abnormal function). Using a combination of these logs, we can readily identify abnormal pump operation such as the development and progression of pump thrombosis, suction events and gastrointestinal bleeding. However, the research potential of log files was not discussed in these publications, particularly as it pertains to areas such as studying speed modulation and pulsatility in VADs. Conclusions VADs are an important staple in the treatment of patients with refractory HF. Log files provide a treasure-trove of information and knowledge that can be utilised for clinical benefit. Furthermore, log files provide an excellent tool for conducting research into device functionality. Current literature on the clinical utility of log files is sparse with much untapped potential. Keywords Ventricular assist device log files
LVADs background Advancements in medical technology and emerging treatments have led to a significant decline in cardiovascular mortality; however, heart failure (HF) has emerged as a growing epidemic in the twenty-first century. Despite optimal medical management, HF mortality remains high with an aggregate 50% 5-year survival rate and similar 1-year survival rates in those with advanced refractory HF [1–3]. Orthotopic heart transplantation remains the gold standard of treatment in patients with advanced refractory HF. Thanks
* Christopher Simon Hayward [email protected] 1
Cardiology Department, St Vincent’s Hospital, Sydney, Australia
2
School of Medicine, University of New South Wales, Sydney, Australia
3
School of Medicine, University of Notre Dame, Sydney, Australia
4
Victor Chang Cardiac Research Institute, Sydney, Australia
to modern improvements, 1- and 5-year survival rates of 86% and 79%, respectively, are expected in recip
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