Haneya, Assad and Philipp, Alois and Puehler, Thomas and Ried, Michael and Hilker, Michael and Zink, Wolfgang and Hirt, Stephan W. and Schmid, Christof (2012) Ventricular assist device implantation in patients on percutaneous extracorporeal life support without switching to conventional cardiopulmonary bypass system. EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 41 (6). pp. 1366-1370. ISSN 1010-7940,
Full text not available from this repository. (Request a copy)Abstract
Ventricular assist device (VAD) implantation using cardiopulmonary bypass (CPB) is an established procedure. However, the well-described complications of CPB may exacerbate multiple organ failure and increase blood product transfusions especially in end-stage heart failure patients. We describe our successful experience in six consecutive patients with profound cardiogenic shock, who were provided on an emergency basis with a percutaneous extracorporeal life support (ECLS) system via the peripheral vessels. After stabilization, a VAD was implanted using ECLS without switching to a conventional CPB system to reduce its side effects. We compared the data with those of 11 patients in whom the VAD was placed with the aid of an additional CPB system. The six patients demonstrated a shorter duration of operating room time compared with the patients requiring CPB for device placement. During and after surgery, blood loss and blood product transfusions were lower in these patients. The need for mechanical ventilation and inotropic support was shorter and the survival rate (100% at 30 days, 83.3% at 3 months and 83.3% at 6 months) was higher when compared with patients who were operated upon with CPB. Two patients were successfully bridged to transplantation. One patient died due to cerebral bleeding after 7 weeks. Our experience suggests that VAD implantation using percutaneous ECLS without switching to conventional CPB is a safe alternative in the bridge to bridge concept, especially in high-risk patients with cardiogenic shock who would benefit from the avoidance of the adverse sequels associated with conventional CPB.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | OFF-PUMP INSERTION; MEMBRANE-OXYGENATION; CARDIOGENIC-SHOCK; HEART; SURVIVAL; THERAPY; BRIDGE; Ventricular assist device; Extracorporeal life support; Cardiopulmonary bypass; Cardiogenic shock |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 13 May 2020 06:58 |
| Last Modified: | 13 May 2020 06:58 |
| URI: | https://pred.uni-regensburg.de/id/eprint/18688 |
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