دورية أكاديمية
Use of a percutaneous left ventricular assist device for high-risk cardiac interventions and cardiogenic shock.
| العنوان: | Use of a percutaneous left ventricular assist device for high-risk cardiac interventions and cardiogenic shock. |
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| المؤلفون: | Thomas JL; Division of Cardiology, Good Samaritan Hospital, Los Angeles, California, USA., Al-Ameri H, Economides C, Shareghi S, Abad DG, Mayeda G, Burstein S, Shavelle DM |
| المصدر: | The Journal of invasive cardiology [J Invasive Cardiol] 2010 Aug; Vol. 22 (8), pp. 360-4. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: HMP Communications Country of Publication: United States NLM ID: 8917477 Publication Model: Print Cited Medium: Internet ISSN: 1557-2501 (Electronic) Linking ISSN: 10423931 NLM ISO Abbreviation: J Invasive Cardiol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Malvern, PA : HMP Communications Original Publication: [King of Prussia, PA] : Health Management Publications, [c1988- |
| مواضيع طبية MeSH: | Heart-Assist Devices* , Severity of Illness Index*, Heart Diseases/*surgery , Shock, Cardiogenic/*surgery, Aged ; Aged, 80 and over ; Aortic Valve Stenosis/epidemiology ; Aortic Valve Stenosis/surgery ; Cardiomyopathies/epidemiology ; Cardiomyopathies/surgery ; Female ; Follow-Up Studies ; Heart Diseases/epidemiology ; Humans ; Male ; Middle Aged ; Myocardial Infarction/epidemiology ; Myocardial Infarction/surgery ; Myocarditis/epidemiology ; Myocarditis/surgery ; Retrospective Studies ; Risk Factors ; Shock, Cardiogenic/epidemiology ; Treatment Outcome |
| مستخلص: | Objective: We sought to describe the use of the TandemHeart percutaneous left ventricular assist device (PVAD) in a group of high-risk patients undergoing complex cardiovascular procedures. Background: There is a substantial risk of acute decompensation and death in patients with cardiogenic shock or a reduced cardiac reserve undergoing high-risk cardiovascular interventions. The TandemHeart PVAD provides near-total hemodynamic support in this setting. Methods: Thirty-seven high-risk patients underwent placement of the TandemHeart PVAD during 38 separate procedures between April 2007 and April 2009. PVAD insertion was considered emergent if a patient was not expected to survive more than 6 hours without PVAD support. Technical success was defined as successful initiation of the PVAD and completion of the intended interventional procedure. Results: All 37 patients were in cardiogenic shock or undergoing complex coronary and valvular interventions with a high probability of hemodynamic collapse. The mean (+/- standard deviation) patient age was 73 +/- 14 years; 97% were in either NYHA class III-IV heart failure or cardiogenic shock; and the mean EuroSCORE was 11 +/- 3.4. Indications for ventricular assist device placement included critical aortic stenosis (n = 8), severe left main coronary stenosis (n = 18), severe multivessel coronary stenosis (n = 19) and severe cardiomyopathy (n = 23). Four patients were being managed for fulminant myocarditis, ventricular free-wall rupture, flail mitral valve or severe paravalvular leak. Despite their critical status and frequent (82%) need for post-procedure blood transfusion, this complex and high-risk patient population tolerated PVAD-supported intervention well and technical success was achieved in all patients. Seventy-one percent of patients survived to hospital discharge with improved functional status. Most deaths occurred in patients not expected to survive due to their moribund status and multiorgan failure. Conclusion: This experience demonstrates the utility and effectiveness of TandemHeart PVAD support in patients with advanced disease, critical clinical status and limited therapeutic options. |
| تواريخ الأحداث: | Date Created: 20100804 Date Completed: 20101116 Latest Revision: 20100803 |
| رمز التحديث: | 20231215 |
| PMID: | 20679671 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1557-2501 |
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