Document Detail


Ventricular assist device use with mechanical heart valves: an outcome series and literature review.
MedLine Citation:
PMID:  11789792     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Management of postcardiotomy cardiogenic shock with a ventricular assist device (VAD) is a common and accepted therapeutic option. However, VAD use in patients with mechanical heart valves (MHVs) is thought to carry an increased risk of thromboembolus. We report a series of 7 patients with combined VAD-MHV and review the literature. METHODS: A retrospective review was performed on all patients who were supported with a ventricular assist device with a mechanical heart valve in place. A literature review was also performed from 1966 to 2000. RESULTS: Seven patients were identified from April 1988 to June 2000 as having VAD support with a MHV. One thromboembolic event was documented in the 7 patients (14%). Five of the 7 patients (71%) underwent VAD explantation. Overall survival rate was 3 of 7 (43%). Causes of death included heart failure, renal failure, multisystem organ failure, adult respiratory distress syndrome, and cerebral hypoxia. All patients who died had support withdrawn at the request of the family. All patients discharged are currently alive with length of survival of 3, 26, and 84 months. CONCLUSIONS: This study suggests that this population's rate of survival to discharge and risk of thromboembolus compare favorably to that of the general VAD population. We believe that anticoagulation can be managed as with any MHV patient and that flow rates can be kept slightly lower, which may encourage valve washing.
Authors:
W B Tisol; D K Mueller; F B Hoy; R C Gomez; B S Clemson; S M Hussain
Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  72     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2001 Dec 
Date Detail:
Created Date:  2002-01-14     Completed Date:  2002-01-31     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2051-4; discussion 2055     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiovascular and Thoracic Surgery, University of Illinois College of Medicine, Peoria, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cause of Death
Device Removal
Female
Follow-Up Studies
Heart Valve Prosthesis*
Heart-Assist Devices*
Humans
Male
Middle Aged
Postoperative Complications / etiology*,  mortality
Prosthesis Design
Risk Factors
Shock, Cardiogenic / mortality,  surgery*
Survival Analysis
Thromboembolism / etiology*
Treatment Outcome

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


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