Τίτλος:
HeartMate II left ventricular assist device; early European experience
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Objective: The novel axial flow left ventricular assist device HeartMate II was introduced into clinical practice in Europe as part of the pilot study and after CE approval in November 2005. In order to get an overview of the use and performance of the device in Europe a group of investigators was founded to compare the initial results. Methods: In a retrospective analysis of the first 101 consecutive cases in Europe, data were collected with regard to postoperative outcome and severe adverse events and anticoagulation protocols. Results were stratified by intention to treat as a bridge to transplant or as chronic support therapy in heart failure (destination therapy). Results: In 70% of patients, the HeartMate II was intended as a bridge to transplant therapy, in 30%, it was used as a destination therapy device. The perioperative mortality post implant was 20% in the bridge to transplant patients and 7% in the destination therapy arm. However, after 1 year a comparable survival was observed in both groups (69% destination therapy, 63% bridge to transplant). Main causes of death were multiple organ failure (n = 12) and cerebrovascular accidents (n = 5). All, but one cerebrovascular accident occurred in the first 9 days after surgery. Only one other death was reported thereafter and there was no mechanical failure of the device. Conclusions: Even in the early experience the HeartMate II was used as a chronic support device in a substantial number of patients in Europe. Although the total experience is still limited, the incidence of cerebrovascular accidents is very low and the survival beyond the perioperative period is excellent. © 2008 European Association for Cardio-Thoracic Surgery.
Συγγραφείς:
Strüber, M.
Sander, K.
Lahpor, J.
Ahn, H.
Litzler, P.-Y.
Drakos, S.G.
Musumeci, F.
Schlensak, C.
Friedrich, I.
Gustafsson, R.
Oertel, F.
Leprince, P.
Περιοδικό:
European Journal of Cardio-Thoracic Surgery Supplements
Λέξεις-κλειδιά:
antivitamin K; clopidogrel; phenprocoumon; warfarin, adolescent; adult; aged; article; brain ischemia; cause of death; cerebrovascular accident; clinical practice; controlled study; device; heart arrhythmia; heart failure; heart right ventricle failure; hemolysis; human; kidney failure; liver dysfunction; major clinical study; mortality; multiple organ failure; outcome assessment; pneumonia; postoperative hemorrhage; postoperative infection; priority journal; seizure; sepsis; survival rate; transient ischemic attack, Adolescent; Adult; Aged; Anticoagulants; Epidemiologic Methods; Heart Failure; Heart Transplantation; Heart-Assist Devices; Humans; Middle Aged; Multiple Organ Failure; Postoperative Complications; Stroke; Treatment Outcome
DOI:
10.1016/j.ejcts.2008.05.011
