Document Detail

Clinical experience with the TandemHeart percutaneous ventricular assist device as a bridge to cardiac transplantation.
MedLine Citation:
PMID:  19156239     Owner:  NLM     Status:  MEDLINE    
Cardiac support with a ventricular assist device is among the few treatments for heart-failure patients who have profound cardiogenic shock unresponsive to vasopressors and intra-aortic balloon pumps. The TandemHeart percutaneous ventricular assist device can provide temporary support until another device can be placed or a donor heart becomes available. We examined the TandemHeart's effect on cardiac index, central venous pressure, mixed venous oxygen saturation, creatinine, mean arterial pressure, urine output, and 30-day mortality rate in 5 heart-failure patients (2 with nonischemic and 3 with ischemic cardiomyopathy; mean preoperative left ventricular ejection fraction, 0.17 +/- 0.056). Two patients were undergoing cardiopulmonary resuscitation when the device was inserted. The average duration of TandemHeart support was 7.6 +/- 3.2 days; all patients were successfully bridged to transplantation. The TandemHeart improved the cardiac index (1.9 +/- 0.3 vs 3.5 +/- 0.8 L/[min.m2], P= 0.01), mean arterial pressure (69 +/- 12.5 vs 91 +/- 4.3 mmHg, P=0.009), mixed venous oxygen saturation (45.4 +/- 14.3 vs 71.4 +/- 7.5, P=0.009), and urine output (1,861 +/- 988 vs 4,314 +/- 1,346 mL/hr, P=0.01). The device decreased central venous pressure (21.2 +/- 7.4 vs 12.8 +/- 5.9 mmHg, P=0.02) and pressor requirements (2.4 +/- 1.1 vs 1.0 +/- 0.7 agents, P=0.02). Average long-term follow-up after heart transplantation was 8.4 +/- 9.9 months, with no deaths. We conclude that the TandemHeart can provide hemodynamic support for patients with profound, refractory cardiogenic shock. Furthermore, the device can bridge patients to cardiac transplantation and can be placed percutaneously, without invasive surgery.
Brian A Bruckner; Leon P Jacob; Igor D Gregoric; Pranav Loyalka; Biswajit Kar; William E Cohn; Saverio La Francesca; Branislav Radovancevic; O H Frazier
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital     Volume:  35     ISSN:  1526-6702     ISO Abbreviation:  Tex Heart Inst J     Publication Date:  2008  
Date Detail:
Created Date:  2009-01-21     Completed Date:  2009-08-19     Revised Date:  2013-05-23    
Medline Journal Info:
Nlm Unique ID:  8214622     Medline TA:  Tex Heart Inst J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  447-50     Citation Subset:  IM    
Department of Cardiovascular Surgery, The Methodist Hospital, Houston, Texas 77030, USA.
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MeSH Terms
Angioplasty, Balloon, Coronary*
Blood Vessel Prosthesis Implantation
Cardiac Output
Cardiomyopathies / complications*,  therapy
Heart Failure / surgery*,  therapy
Heart Transplantation
Heart-Assist Devices*
Middle Aged
Prospective Studies
Shock, Cardiogenic / prevention & control*
Stroke Volume

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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