Bridging patients in cardiogenic shock with a paracorporeal pulsatile biventricular assist device to heart transplantation-a single-centre experience
© The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved..
OBJECTIVES: We evaluated the outcome of patients in cardiogenic shock receiving a paracorporeal pulsatile biventricular assist device as a bridge to transplantation.
METHODS: We performed a retrospective single-centre analysis of all patients who received a Berlin Heart Excor® at our institution between 2004 and 2019.
RESULTS: A total of 97 patients (90 adults, 7 paediatric) were analysed. Eighty-four patients were in Interagency Registry for Mechanically Assisted Circulatory Support level 1 (80 adults, 4 paediatric). Diagnoses were dilated cardiomyopathy (n = 41), ischaemic cardiomyopathy (n = 17) or myocardial infarction (n = 4), myocarditis (n = 15), restrictive cardiomyopathy (n = 2), graft failure after heart transplant (n = 7), postcardiotomy heart failure (n = 5), postpartum cardiomyopathy (n = 3), congenital heart disease (n = 1), valvular cardiomyopathy (n = 1) and toxic cardiomyopathy (n = 1). All patients were in biventricular heart failure and had secondary organ dysfunction. The mean duration of support was 63 days (0-487 days). There was a significant decrease in creatinine values after assist device implantation (from 1.83 ± 0.79 to 1.12 ± 0.67 mg/dl, P = 0.001) as well as a decrease in bilirubin values (from 3.94 ± 4.58 to 2.65 ± 3.61 mg/dl, P = 0.084). Cerebral stroke occurred in 16 patients, bleeding in 15 and infection in 13 patients. Forty-eight patients died on support, while 49 patients could be successfully bridged to transplantation. Thirty-day survival and 1-year survival were 70.1% and 41.2%, respectively.
CONCLUSIONS: A pulsatile biventricular assist device is a reasonable therapeutic option in cardiogenic shock, when immediate high cardiac output is necessary to rescue the already impaired kidney and liver function of the patient.
| Errataetall: |
CommentIn: Eur J Cardiothorac Surg. 2022 Mar 24;61(4):950-951. - PMID 35025985 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:61 |
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| Enthalten in: |
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery - 61(2022), 4 vom: 24. März, Seite 942-949 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Michel, Sebastian [VerfasserIn] |
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| Links: |
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| Themen: |
Biventricular assist device |
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| Anmerkungen: |
Date Completed 07.04.2022 Date Revised 07.04.2022 published: Print CommentIn: Eur J Cardiothorac Surg. 2022 Mar 24;61(4):950-951. - PMID 35025985 Citation Status MEDLINE |
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| doi: |
10.1093/ejcts/ezab547 |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a Bridging patients in cardiogenic shock with a paracorporeal pulsatile biventricular assist device to heart transplantation-a single-centre experience |
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| 500 | |a Date Revised 07.04.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: Eur J Cardiothorac Surg. 2022 Mar 24;61(4):950-951. - PMID 35025985 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. | ||
| 520 | |a OBJECTIVES: We evaluated the outcome of patients in cardiogenic shock receiving a paracorporeal pulsatile biventricular assist device as a bridge to transplantation | ||
| 520 | |a METHODS: We performed a retrospective single-centre analysis of all patients who received a Berlin Heart Excor® at our institution between 2004 and 2019 | ||
| 520 | |a RESULTS: A total of 97 patients (90 adults, 7 paediatric) were analysed. Eighty-four patients were in Interagency Registry for Mechanically Assisted Circulatory Support level 1 (80 adults, 4 paediatric). Diagnoses were dilated cardiomyopathy (n = 41), ischaemic cardiomyopathy (n = 17) or myocardial infarction (n = 4), myocarditis (n = 15), restrictive cardiomyopathy (n = 2), graft failure after heart transplant (n = 7), postcardiotomy heart failure (n = 5), postpartum cardiomyopathy (n = 3), congenital heart disease (n = 1), valvular cardiomyopathy (n = 1) and toxic cardiomyopathy (n = 1). All patients were in biventricular heart failure and had secondary organ dysfunction. The mean duration of support was 63 days (0-487 days). There was a significant decrease in creatinine values after assist device implantation (from 1.83 ± 0.79 to 1.12 ± 0.67 mg/dl, P = 0.001) as well as a decrease in bilirubin values (from 3.94 ± 4.58 to 2.65 ± 3.61 mg/dl, P = 0.084). Cerebral stroke occurred in 16 patients, bleeding in 15 and infection in 13 patients. Forty-eight patients died on support, while 49 patients could be successfully bridged to transplantation. Thirty-day survival and 1-year survival were 70.1% and 41.2%, respectively | ||
| 520 | |a CONCLUSIONS: A pulsatile biventricular assist device is a reasonable therapeutic option in cardiogenic shock, when immediate high cardiac output is necessary to rescue the already impaired kidney and liver function of the patient | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Biventricular assist device | |
| 650 | 4 | |a Cardiogenic shock | |
| 650 | 4 | |a Heart transplant | |
| 650 | 4 | |a Pulsatile ventricular assist device | |
| 700 | 1 | |a Buchholz, Stefan |e verfasserin |4 aut | |
| 700 | 1 | |a Buech, Joscha |e verfasserin |4 aut | |
| 700 | 1 | |a Veit, Tobias |e verfasserin |4 aut | |
| 700 | 1 | |a Fabry, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Abicht, Jan |e verfasserin |4 aut | |
| 700 | 1 | |a Thierfelder, Nikolaus |e verfasserin |4 aut | |
| 700 | 1 | |a Mueller, Christoph |e verfasserin |4 aut | |
| 700 | 1 | |a Rosenthal, Laura Lily |e verfasserin |4 aut | |
| 700 | 1 | |a Pabst von Ohain, Jelena |e verfasserin |4 aut | |
| 700 | 1 | |a Haas, Nikolaus |e verfasserin |4 aut | |
| 700 | 1 | |a Hörer, Jürgen |e verfasserin |4 aut | |
| 700 | 1 | |a Hagl, Christian |e verfasserin |4 aut | |
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