Physiology of Blood Pump Circulation in Heart Failure

In the current era of mechanical circulatory support, blood pumps play a crucial role in providing hemodynamic support in patients with end-stage chronic heart failure, and their use is expected to increase with the development of newer and better pumps. Optimal use of LVADs can facilitate LV unloading and reverse remodeling of the native heart. LVAD optimization, however, requires a comprehensive understanding of the physiology ventricular mechanics, the hemodynamics of blood pumps, and the interaction between the VAD, native ventricle, and the circulation. Knowledge of pump physiology is also vital for early identification and prevention of catastrophic conditions such as pump thrombosis and RV failure. In this chapter, we present a comprehensive clinically relevant review of the physiology of LVADs as applied to patients with chronic heart failure.