Document Detail


Experience with over 1000 implanted ventricular assist devices.
MedLine Citation:
PMID:  18435629     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  23     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:    2008 May-Jun
Date Detail:
Created Date:  2008-04-25     Completed Date:  2008-08-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  185-94     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Germany. potapov@dhzb.de
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MeSH Terms
Descriptor/Qualifier:
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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