Document Detail


Use of the AB5000 ventricular assist device in cardiogenic shock after acute myocardial infarction.
MedLine Citation:
PMID:  20732481     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The mortality rate of patients experiencing acute myocardial infarction (AMI) complicated by cardiogenic shock remains high. After conventional therapies have failed, ventricular assist devices (VADs) have been used to bridge patients to recovery or transplantation. METHODS: A voluntary US registry was established to track all patients implanted with the AB5000 VAD. We report the results of the first 100 patients in the registry with the indication of AMI cardiogenic shock. Data were retrospectively reviewed for demographics, preimplant condition, surgical techniques, and outcomes. Survival was assessed at 30 days after VAD explant or at discharge. Myocardial recovery (subset of survival) was defined as satisfactory unassisted native cardiac function for 30 days after VAD explant or at discharge. RESULTS: Forty patients (40%) survived to 30 days after VAD explant or discharge of the first 100 patients. Of the survivors, 63% (n = 25) experienced myocardial recovery. Patients who recovered required an average of 25 +/- 22 days of VAD support. The estimated survival after explant for the recovery patients at 2 years after VAD explant was 78%. CONCLUSIONS: Results from this nationwide registry suggest that VADs can restore normal hemodynamics and support recovery of native cardiac function in the majority of survivors when conventional therapies fail. However, a longer duration of support than previously recognized may be required. In the absence of clinical guidelines, early aggressive use of VAD support in AMI complicated by cardiogenic shock may improve outcomes, and recovery of native cardiac function should always be the primary goal.
Authors:
Mark Anderson; Nicholas Smedira; Louis Samuels; Michael Madani; Yoshifumi Naka; Michael Acker; Mariah Hout; Karim Benali
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  90     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-24     Completed Date:  2010-09-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  706-12     Citation Subset:  AIM; IM    
Copyright Information:
2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Robert Wood Johnson Medical School, New Brunswick, New Jersey 08903, USA. andersm2@umdnj.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Female
Heart-Assist Devices*
Humans
Male
Middle Aged
Myocardial Infarction / complications*
Registries
Retrospective Studies
Shock, Cardiogenic / etiology*,  surgery*
United States

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


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