Document Detail


Mechanical circulatory support with the ABIOMED BVS 5000: the Toronto General Hospital experience.
MedLine Citation:
PMID:  21076718     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Acute hemodynamic collapse resulting in cardiogenic shock and impending end-organ failure is usually associated with certain death. The introduction of short-term mechanical circulatory support (MCS) devices offers potential therapy to these critically ill patients. The BVS 5000 device (ABIOMED Inc, USA) is widely used in the United States, but rarely in Canada, where device reimbursement remains a barrier.
OBJECTIVE: To present the Toronto General Hospital's (Toronto, Ontario) initial five-year experience with this device to highlight the indications for use, common complications and overall success rates.
METHODS AND RESULTS: The institutional MCS database from 2001 to 2006 was reviewed, and 18 patients who received 30 devices in a variety of configurations were identified. The most common support configuration consisted of biventricular support (n=12), followed by isolated left ventricular support (n=4) and isolated right ventricular support in two recipients of an implantable long-term left ventricular assist device. Overall survival to device explant or transplant was 55% (n=10), of which five (50%) were successfully discharged from the hospital. The overall survival from device implant to hospital discharge was 28% (five of 18). The most common cause of death was multisystem organ failure.
CONCLUSIONS: MCS with the ABIOMED BVS 5000 can successfully resuscitate critically ill patients; however, earlier institution of this device would avoid irreversible end-organ injury, and lead to higher rates of device explant and hospital discharge. Short-term MCS devices should be available in all cardiac surgical centres in Canada to permit stabilization and evaluation of the acutely ill cardiac patient and subsequent management in a heart transplant facility.
Authors:
Vidyadhar Lad; Abdelsalam Elhenawy; Steve Harwood; Jane Maciver; Mitesh Vallabh Badiwala; Mark Vallelonga; Terrence M Yau; Robert J Cusimano; Diego H Delgado; Heather J Ross; Vivek Rao
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  26     ISSN:  1916-7075     ISO Abbreviation:  Can J Cardiol     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-15     Completed Date:  2010-12-31     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  467-70     Citation Subset:  IM    
Affiliation:
Heart Transplant Program, Peter Munk Cardiac Centre, Toronto General Hospital and University of Toronto, Toronto, Ontario.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cardiac Surgical Procedures / instrumentation*
Equipment Design
Female
Heart Failure / mortality,  surgery
Heart Transplantation / instrumentation
Heart-Assist Devices* / adverse effects
Hospital Records
Hospitals, General
Humans
Male
Medical Records
Middle Aged
Ontario
Practice Guidelines as Topic
Retrospective Studies
Shock, Cardiogenic / mortality,  surgery
Survival Analysis
Time Factors
Treatment Outcome
Comments/Corrections

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


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