{"id":"f5d7d5148d3e","type":"article","url":"https://hartvaat.nl/2026/09/01/langdurige-lvad-behandeling-klinisch-beheer-en-uitkomsten-in-de-heartmate-3-erat/","title":"Langdurige LVAD-behandeling: klinisch beheer en uitkomsten in de HeartMate 3-eratie","title_en":"Permanent Left Ventricular Assist Devices: Long-Term Management and Outcomes.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":[],"journal":"Clinics in chest medicine","doi":"10.1016/j.ccm.2026.04.014","source_url":"https://doi.org/10.1016/j.ccm.2026.04.014","authors":["Ruben Crespo-Diaz"],"significance":5,"published":"2026-07-31","source_date":"2026-09-01","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/lvad-ventrikelondersteunende-systemen/","https://hartvaat.nl/kennis/hartfalen/wat-is-hartfalen/"],"congress":"","summary_en":"This review outlines the physiological principles and long-term clinical management of durable left ventricular assist devices (LVAD), with a focus on the HeartMate 3 era. While major complications such as pump thrombosis and stroke have declined, gastrointestinal bleeding, right ventricular failure, infection, and arrhythmias remain significant clinical challenges. The article emphasizes that LVAD therapy continues to be a vital strategy for bridge-to-transplant, destination therapy, and potential myocardial recovery amid ongoing organ shortages.","created":"2026-07-24T00:52:58Z","updated":"2026-08-10T10:37:45Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Dit overzicht beschrijft het fysiologische principe en het langdurige klinische beheer van permanente linkerventrikelassistentie-apparaten (LVAD), met nadruk op de HeartMate 3-eratie. Hoewel complicaties zoals pompthrombose en cerebrovasculaire accidenten zijn afgenomen, blijven gastro-intestinale bloedingen, rechterventrikelfalen, infecties en hartritmestoornissen een klinische uitdaging. Het artikel onderstreept dat LVAD-therapie een essentieel instrument blijft als brug naar transplantatie, destination therapy of mogelijk myocardiaal herstel, mede door aanhoudende donororganstekorten.","abstract_original":"This article outlines the historical development, physiologic principles, and contemporary clinical management of durable left ventricular assist devices, with a primary focus on the HeartMate 3 era. An understanding of centrifugal pump physiology, pulsatility index, power, and flow estimation is essential for effective long-term patient management. While major complications such as pump thrombosis and stroke have declined, gastrointestinal bleeding, right ventricular failure, infection, arrhythmias, and outflow graft obstruction remain a significant clinical challenge. Nonetheless, left ventricular assist device therapy as a bridge to transplant, destination therapy, and even recovery are feasible strategies in the context of ongoing donor organ shortages."}