| Experience with over 1000 implanted ventricular assist devices. | |
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MedLine Citation:
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PMID: 18435629 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: The use of ventricular assist devices (VADs) in patients with chronic end-stage or acute heart failure has led to improved survival. We present our experience since 1987. SUBJECTS AND METHODS: Between July 1987 and December 2006, 1026 VADs were implanted in 970 patients. Most of them were men (81.9%). The indications were: cardiomyopathy (n = 708), postcardiotomy heart failure (n = 173), acute myocardial infarction (n = 36), acute graft failure (n = 45), a VAD problem (n = 6), and others (n = 2). Mean age was 46.1 (range 3 days to 78) years. In 50.5% of the patients the VAD implanted was left ventricular, in 47.9% biventricular, and in 1.5% right ventricular. There were 14 different types of VAD. A total artificial heart was implanted in 14 patients. RESULTS: Survival analysis showed higher early mortality (p < 0.05) in the postcardiotomy group (50.9%) than in patients with preoperative profound cardiogenic shock (31.1%) and patients with preoperative end-stage heart failure without severe shock (28.9%). A total of 270 patients were successfully bridged to heart transplantation (HTx). There were no significant differences in long-term survival after HTx among patients with and without previous VAD. In 76 patients the device could be explanted after myocardial recovery. In 72 patients the aim of implantation was permanent support. During the study period 114 patients were discharged home. Currently, 54 patients are on a device. CONCLUSIONS: VAD implantation may lead to recovery from secondary organ failure. Patients should be considered for VAD implantation before profound, possibly irreversible, cardiogenic shock occurs. In patients with postcardiotomy heart failure, a more efficient algorithm should be developed to improve survival. With increased experience, more VAD patients can participate in out-patient programs. |
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Authors:
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Evgenij V Potapov; Antonio Loforte; Yuguo Weng; Michael Jurmann; Miralem Pasic; Thorsten Drews; Matthias Loebe; Ewald Hennig; Thomas Krabatsch; Andreas Koster; Hans B Lehmkuhl; Roland Hetzer |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of cardiac surgery Volume: 23 ISSN: 0886-0440 ISO Abbreviation: J Card Surg Publication Date: 2008 May-Jun |
Date Detail:
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Created Date: 2008-04-25 Completed Date: 2008-08-29 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8908809 Medline TA: J Card Surg Country: United States |
Other Details:
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Languages: eng Pagination: 185-94 Citation Subset: IM |
Affiliation:
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Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Germany. potapov@dhzb.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Child Child, Preschool Equipment Design Female Heart Failure / mortality*, surgery* Heart-Assist Devices / statistics & numerical data* Humans Infant Infant, Newborn Male Middle Aged Patient Discharge Survival Analysis Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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