Benefit of paracorporeal pulsatile assist device in multiorgan failing patients in terminal stage of heart failure
Authors:
Ivan Netuka 1,4; Jiří Malý 1,4; Hynek Říha 3; Ondrej Szárszoi 1,4; Zora Dorazilová 2; Ivo Skalsky 1; Daniel Turek 1; Marián Urban 1; Jiří Kettner 2; Jan Pirk 1,4
Authors‘ workplace:
Institut klinické a experimentální medicíny Praha, Klinika kardiovaskulární chirurgie
1; Institut klinické a experimentální medicíny Praha, Klinika kardiologie
2; Institut klinické a experimentální medicíny Praha, Klinika anesteziologie a resuscitace
3; Institut klinické a experimentální medicíny Praha, Centrum výzkumu chorob srdce a cév
4
Published in:
Čas. Lék. čes. 2011; 150: 44-48
Category:
Original Article
Overview
Background:
Prevalence of terminal forms of heart failure is steadily increasing and thus waiting time for heart transplantation, too. Increasing mortality on waiting list has urged implementation of mechanical circulatory support as an adjunct to the programme of heart transplantation. The objective of the study is to review 7-years experience with paracorporeal assist device in bridging to transplantation.
Material and methods:
Retrospective review of 53 transplant candidates treated since April 2003. 50 patients received paracorporeal assist devices in biventricular configuration. Most frequent diagnosis was dilated cardiomyopathy in 51%.
Results.
Despite a high risk profile of the patients, 37 of them were successfully transplanted (69.8%). Cumulative support has reached 3513 days. Local exit sites infection was identified as a most frequent complication, sepsis as a most frequent cause of death on support (18.8%). 30‑days post – transplant mortality remained low at 5.7%.
Conclusions:
Paracorporeal mechanical circulatory assist devices remain effective alternative for terminal stage heart transplant candidates, especially for those in multiorgan failure who require biventricular support. Success rate of bridging to transplantation is acceptable, as well as complications rate and quality of life while on support. Long-term post-transplant survival is not inferior to the results of procedures performed without necessity of previous implantation of the assist device.
Key words:
heart transplantation, ventricular assist device, biventricular configuration, paracorporeal, multiorgan failure.
Sources
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Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain managementArticle was published in
Journal of Czech Physicians
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