Mechanical circulatory assistance after heart transplantation

Differential indication for mechanical circulatory support following heart transplantation

“…Kanter [8] reports 11 cases following 59 transplantations; Emery [9] reports 9 after 89 transplantations. Many case reports also exist, how-1324 1 3 0 Neurological 2 0 0 Liver failure 2 5 1 Acute kidney failure 3 4 1 Multiple organ failure 3 4 2 Sepsis 3 2 2 Patient-related infections 3 1 2 System-related infections 0 0 0 Haemolysis 0 4 0 Thrombosis 1 0 0 ever.…”

“…Most of them are concerned with the successful use of MCS in conjunction with RHF [10,11,12,14,15]. Others report the treatment of PGF with LVAD [9,18] or with BVAD [16,17,19,20]. On the basis of an evaluation of more than 200 cases with MCS in our hospital [2,4,5,6,7] the advantages and disadvantages of the individual systems could be proven.…”

Use of Mechanical Circulatory Support in Pediatric Patients With Acute Cardiac Graft Rejection

“…10 -16 The use of MCS to treat cardiac failure caused by acute graft rejection has been reported in small series in adults but not in the pediatric population except from an earlier report from this institution. [17][18][19][20][21][22][23][24] When patients with graft rejection and hemodynamic instability are mechanically supported, the circulation is secured, allowing for aggressive immunosuppressive strategies. 25 This manuscript reports the use of MCS at Texas Children's Hospital in patients with severe acute cardiac allograft rejection causing hemodynamic instability.…”

Insertion of Right Ventricular Assist Device and Its Removal Under Local Anesthesia

“…Mechanical right ventricular assistance has been used in a variety of conditions for which temporary support of the failing right ventricle is indicated. Reports in the literature regarding the use of RVADs after both cardiac transplantation and left ventricular assist devices (LVAD) insertion, however, have generated conflicting results 5‐9 . The need for right ventricular mechanical support in patients who have received an LVAD has decreased significantly due to the increased use of inhaled nitric oxide and selective pulmonary vasodilators 10‐12 .…”

“…Reports in the literature regarding the use of RVADs after both cardiac transplantation and left ventricular assist devices (LVAD) insertion, however, have generated conflicting results. [5][6][7][8][9] The need for right ventricular mechanical support in patients who have received an LVAD has decreased significantly due to the increased use of inhaled nitric oxide and selective pulmonary vasodilators. [10][11][12] The RV failure will develop in approximately 25% of patients receiving LVAD support.…”