scholarly journals Temporary mechanical circulatory support in heart transplant candidates

2018 ◽  
Vol 19 (4) ◽  
pp. 113-123
Author(s):  
V. N. Poptsov ◽  
E. A. Spirina ◽  
S. G. Ukhrenkov ◽  
D. M. Bondarenko ◽  
A. A. Dogonasheva ◽  
...  
Keyword(s):  
Heart Transplant ◽  
Mechanical Circulatory Support ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Circulatory Support ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Organizational Conditions ◽  
Effi Ciency ◽  
Transplant Candidates

Implantable left ventricular assist devices (LVAD) have become the leading method of mechanical circulatory support (MCS) in heart transplant candidates. But the temporary MCS as a mechanical bridge to heart transplantation (HT) continues to use. The temporary MCS remains an effi ciency method of treatment of life-threatening heart failure (HF), when implantation of permanent LVAD or BiVAD is associated with high risk. The temporary MCS creates clinical and organizational conditions for the urgent HT. This approach allows not only to save life of heart transplant candidates, but also to improve the availability of the HT. The choice of the temporary MCS is determined by the type and severity of HF and the expected duration of its application. The review presents a characteristic, and discusses the effectiveness of various methods of temporary MCS at heart transplant candidates needed in urgent HT.

scholarly journals Fatal Flaw – Driveline Fracture as a Rare But Serious Complication Of Mechanical Circulatory Support With Left Ventricular Assist Devices

2017 ◽  
Author(s):  
Yuri Boyechko ◽  
Thomas Tribble ◽  
Maya Guglin
Keyword(s):  
Heart Transplant ◽  
Mechanical Circulatory Support ◽  
Rare Complication ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Circulatory Support ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Assist Devices ◽  
Left Ventricular Assist

Background Patients with advanced heart failure have seen decreased mortality and improved quality of life due to mechanical circulatory support with left ventricular assist devices (LVAD). Regardless of such outcomes, many complications still exist and remain a significant cause of morbidity and mortality. Our purpose is to study the prevalence, clinical course, and outcomes specifically of patients with LVAD driveline (DL) fractures. Methods This single-center, retrospective review included all patients at our institution who had continuous flow LVADs and experienced DL fracture/injury from January 2012 - December 2015. Results Thirteen of 110 LVAD patients (11.8%) had DL fractures (Table 1). Time from implant to time of fracture was 23+/-16.5 months. The majority of fractures were external (62%), due to trauma (i.e. cut during dressing change). Internal injury, proximal to the cutaneous exit site, occurred in 38% of patients, usually due to unknown causes. Only one patient (7.6%) survived on LVAD support. One survived LVAD explant, two underwent pump exchange, and four others underwent heart transplantation. The remaining 5 expired. All patients with untreated internal fractures died (60%). Conclusions Driveline fracture is a rare complication of LVAD and is often lethal when it occurs. Only one patient in our cohort survived without the need for heart transplant, LVAD exchange, or explant. Internal driveline fractures portend a very high mortality. Driveline fracture, especially one that cannot be promptly repaired or if internal fracture is suspected, requires immediate pump exchange or listing for heart transplant.

Psychiatric problems of heart transplant candidates with left ventricular assist devices

2006 ◽  
Vol 9 (4) ◽  
pp. 203-208 ◽  
Author(s):  
Atsushi Baba ◽  
Goichi Hirata ◽  
Fujio Yokoyama ◽  
Kyouichi Kenmoku ◽  
Miyoko Tsuchiya ◽  
...  
Keyword(s):  
Heart Transplant ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Assist Devices ◽  
Left Ventricular Assist ◽  
Transplant Candidates ◽  
Psychiatric Problems

Development of Mechanical Circulatory Support Devices: 55 Years and Counting

2021 ◽  
Vol 32 (4) ◽  
pp. 424-433
Author(s):  
Emalie Petersen
Keyword(s):  
Mechanical Circulatory Support ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Circulatory Support ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Assist Devices ◽  
Left Ventricular Assist ◽  
Mechanical Circulatory Support Devices ◽  
Support Devices

Heart failure is a leading cause of morbidity and mortality in the United States. Treatment of this condition increasingly involves mechanical circulatory support devices. Even with optimal medical therapy and use of simple cardiac devices, heart failure often leads to reduced quality of life and a shortened life span, prompting exploration of more advanced treatment approaches. Left ventricular assist devices constitute an effective alternative to cardiac transplantation. These devices are not without complications, however, and their use requires careful cooperative management by the patient’s cardiology team and primary care provider. Left ventricular assist devices have undergone many technological advancements since they were first introduced, and they will continue to evolve. This article reviews the history of different types of left ventricular assist devices, appropriate patient selection, and common complications in order to increase health professionals’ familiarity with these treatment options.

scholarly journals Prediction of survival of patients in cardiogenic shock treated by surgically implanted Impella 5+ short-term left ventricular assist device

2020 ◽  
Vol 31 (4) ◽  
pp. 475-482
Author(s):  
Gaik Nersesian ◽  
Carsten Tschöpe ◽  
Frank Spillmann ◽  
Tom Gromann ◽  
Luise Roehrich ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Cardiogenic Shock ◽  
Mechanical Circulatory Support ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Circulatory Support ◽  
Left Ventricular Assist Devices ◽  
Short Term ◽  
Ventricular Assist ◽  
Left Ventricular Assist

Abstract OBJECTIVES Short-term mechanical circulatory support is a life-saving treatment for acute cardiogenic shock (CS). This multicentre study investigates the preoperative predictors of 30-day mortality in CS patients treated with Impella 5.0 and 5.5 short-term left ventricular assist devices. METHODS Data of patients in CS (n = 70) treated with the Impella 5 (n = 63) and 5.5 (n = 7) in 2 centres in Berlin between October 2016 and October 2019 were collected retrospectively. RESULTS CS was caused by acute myocardial infarction (n = 16), decompensated chronic heart failure (n = 41), postcardiotomy syndrome (n = 5) and acute myocarditis (n = 8). Before implantation 12 (17%) patients underwent cardiopulmonary resuscitation and 32 (46%) patients were ventilated. INTERMACS level 1, 2 and 3 was established in 35 (50%), 29 (41%) and 6 (9%) of patients, respectively. The mean preoperative lactate level was 4.05 mmol/l. The median support time was 7 days (IR= 4–15). In 18 cases, the pump was removed for myocardial recovery, in 22 cases, durable left ventricular assist devices were implanted, and 30 patients died on support. The overall 30-day survival was 51%. Statistical analysis showed that an increase in lactate per mmol/l [odds ratio (OR) 1.217; P = 0.015] and cardiopulmonary resuscitation before implantation (OR 16.74; P = 0.009) are predictors of 30-day survival. Based on these data, an algorithm for optimal short-term mechanical circulatory support selection is proposed. CONCLUSIONS Impella treatment is feasible in severe CS. Severe organ dysfunction, as well as the level and duration of shock predict early mortality. An algorithm based on these parameters may help identify patients who would benefit from Impella 5+ support.

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