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Titolo:
Emergency ventricular assist device: Better survival rates in non-post cardiotomy-related cardiogenic shock
Autore:
Rodrigus, IE; Amsel, BJ; Conraads, V; De Hert, S; Moulijn, AC;
Indirizzi:
Univ Antwerp Hosp, Dept Cardiac Surg, Edegem, Belgium Univ Antwerp Hosp Edegem Belgium sp, Dept Cardiac Surg, Edegem, Belgium
Titolo Testata:
ACTA CHIRURGICA BELGICA
fascicolo: 5, volume: 101, anno: 2001,
pagine: 226 - 231
SICI:
0001-5458(200110)101:5<226:EVADBS>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
DELAYED STERNAL CLOSURE; CIRCULATORY SUPPORT; BIVENTRICULAR ASSIST; REGISTRY EXPERIENCE; MECHANICAL SUPPORT; ACUTE MYOCARDITIS; BVS-5000; ADVANTAGES;
Keywords:
ventricular assist device; cardiogenic shock; heart transplantation;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
25
Recensione:
Indirizzi per estratti:
Indirizzo: Rodrigus, IE Univ Antwerp Hosp, Dept Cardiac Surg, Edegem, Belgium Univ Antwerp Hosp Edegem Belgium iac Surg, Edegem, Belgium
Citazione:
I.E. Rodrigus et al., "Emergency ventricular assist device: Better survival rates in non-post cardiotomy-related cardiogenic shock", ACT CHIR B, 101(5), 2001, pp. 226-231

Abstract

Objective : the Abiomed BVS 5000 ventricular assist device (VAD) has been approved in Belgium for emergency cardiac support in patients with postcardiotomy failure with the aim of native heart function recovery. Other indications have emerged from world wide experience, but the indication and usefulness of emergency implantation of assist devices is often debated. Methods : to decide which patients benefit most from emergency ventricularassist device implantation, we retrospectively reviewed our results of mechanical circulatory support with Abiomed in 20 patients over a 4-year period. Fifteen patients with mean age 58 +/- 6 years experienced postcardiotomyfailure and underwent biventricular assist device (BVAD) implantation (group A), after elective (n = 9) or after emergency coronary artery bypass grafting (CABG) (n = 6). Five patients (group B), with mean age 35 +/- 19 years, had an implantation for other underlying conditions hypertrophic cardiomyopathy (n = 3), myocarditis (n = 1) and primary cardiac allograft failure (n = 1). Results : Of these two groups, eight and two patients respectively needed cardiopulmonary resuscitation before VAD implantation. The mean duration ofsupport in both groups was 5.8 (range 12h-13days) and 4.4 days (range 2h-9days) respectively. Six and two patients could be weaned from the device and nine and one patients respectively, died on the device. Two patients in group B underwent succesful heart transplantation and four patients in group A died after weaning. Two patients in the postcardiotomy group and four patients in group B survived (13% and 80%) with an overall survival and discharge rate of 30%. Conclusion : although sample sizes are small, better survival rates with emergency Abiomed BVS 5000 implantation were obtained in the non postcardiotomy group (group B). For patients in the postcardiotomy group, outcome was negatively influenced by cardiac arrest and resuscitation before urgent CABG. Since death is the only alternative for these patients in cardiogenic shock and organ recovery cannot be predicted, we continue to consider emergency VAD implantation in this patient population.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/01/20 alle ore 14:28:26