Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
The use of extracorporeal life support in adult patients with primary cardiac failure as a bridge to implantable left ventricular assist device
Autore:
Pagani, FD; Aaronson, KD; Swaniker, F; Bartlett, RH;
Indirizzi:
Univ Michigan, Heart Transplant & Circulatory Assist Program, Sect CardiacSurg, Ann Arbor, MI 48109 USA Univ Michigan Ann Arbor MI USA 48109 CardiacSurg, Ann Arbor, MI 48109 USA
Titolo Testata:
ANNALS OF THORACIC SURGERY
fascicolo: 3, volume: 71, anno: 2001, supplemento:, S
pagine: S77 - S81
SICI:
0003-4975(200103)71:3<S77:TUOELS>2.0.ZU;2-V
Fonte:
ISI
Lingua:
ENG
Soggetto:
POSTCARDIOTOMY CARDIOGENIC-SHOCK; MEMBRANE-OXYGENATION; TRANSPLANTATION; SURVIVAL; EXPERIENCE; MORTALITY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
21
Recensione:
Indirizzi per estratti:
Indirizzo: Pagani, FD Univ Michigan, Heart Transplant & Circulatory Assist Program, Sect CardiacSurg, Taubman 2120,Box 0348,1500 E Med Ctr Dr, Ann Arbor, MI 48109 USA Univ Michigan Taubman 2120,Box 0348,1500 E Med Ctr Dr Ann Arbor MI USA 48109
Citazione:
F.D. Pagani et al., "The use of extracorporeal life support in adult patients with primary cardiac failure as a bridge to implantable left ventricular assist device", ANN THORAC, 71(3), 2001, pp. S77-S81

Abstract

Background. Extracorporeal life support (ECLS) is an effective technique for providing emergent circulatory assistance, and may represent a life-saving option in patients who might not initially be considered a candidate forother forms of circulatory support (extracorporeal or implantable left ventricular assist device [LVAD]). In the setting of cardiac arrest, ECLS represents the only viable method of initiating circulatory support. However, ECLS has a number of disadvantages that include high complication rates (eg,stroke, bleeding) and a limited duration of potential support, which have prevented its widespread acceptance, particularly in the adult population. With the increased successful application of longterm implantable LVADs as a bridge to transplant, the major limitation of ECLS could be overcome by bridging patients to a long-term implantable LVAD ("bridge to bridge"), thereby reducing the reluctance to utilize ECLS when indicated. After acquisition of the HeartMate LVAD (Thermo Cardiosystems, Inc, Woburn, MA) we investigated the use of ECLS as a bridge to an implantable LVAD and subsequent transplantation in selected high-risk patients. Methods and Results. From Oct 1, 1996 to Sept 30, 2000, 33 adult patients presenting with cardiac arrest or severe hemodynamic instability were placed on ECLS for the bridge to bridge indication. Of the 33 patients, 10 patients survived to LVAD implant, 1 was bridged directly to transplant, 5 weaned from ECLS, and 16 died on ECLS. Overall, 12 patients survived to discharge. One-year actuarial survival from the initiation of ECLS was 36%. One-year actuarial survival from the time of LVAD implant, conditional on surviving ECLS, was 80%. Conclusions. The 1-year survival of adult patients placed on ECLS and who subsequently survived to an implantable LVAD was favorable. These data support a strategy of ECLS to implantable LVAD bridge to heart transplant in adult patients who are in need of circulatory support and who are not initially candidates for other forms of mechanical support. The favorable results of this strategy support utilization of ECLS even in situations where myocardial recovery is thought to be unlikely. (C) 2001 by The Society of Thoracic Surgeons.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 00:21:00