Overseas transport of a patient with an extracorporeal left ventricular assist device

Matsuwaka, R; Matsuda, Hikaru; Kaneko, Mitsunori; Miyamoto, Yuji; Masai, Takafumi; Nakatani, Takeshi; Sasaki, Eisaku; Frazier, O.H.

doi:10.1016/0003-4975(94)00583-s

Cited by 24 publications

(10 citation statements)

References 3 publications

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“…Matsuwaka et al 14 report the fixed-wing transport of an 18-year-old male Toyobo (Toyobo, Osaka, Japan) LVAD patient from Osaka, Japan, to Houston, TX. Matsuwaka et al 14 report the fixed-wing transport of an 18-year-old male Toyobo (Toyobo, Osaka, Japan) LVAD patient from Osaka, Japan, to Houston, TX.…”

Section: Discussionmentioning

confidence: 99%

First Berlin Heart EXCOR Pediatric VAD Interhospital Transports of Nonambulatory Patients with the Ikus Stationary Driver

Woolley¹,

Dady²,

Spinnato³

et al. 2013

ASAIO Journal

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Ventricular assist devices (VADs) are increasingly being used in pediatric patients to support cardiac failure. As more centers adopt this technology, there may be a need to transport these patients over long distances to facilitate patient care and organ transplantation. Food and Drug Administration indications for use state only that the patient must be a candidate for transplantation and does not place restrictions on the transplant capabilities of the implanting medical center. Nontransplanting institutions are able to use this technology with a predetermined agreement to transfer the patient to a partnering transplant center. We report the first two cases of interhospital air and ground transport of nonambulatory or intubated pediatric (<13 kg) patients supported by Berlin Heart EXCOR pediatric VADs and Ikus stationary drivers. We present our protocol for transporting this delicate patient population. In addition, we discuss important challenges encountered on these operations regarding vehicle transfers and the management of vehicle power supply. These two cases demonstrate that the transportation of pediatric patients on Berlin Heart VADs is feasible and safe and should be considered a treatment option in certain situations.

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Section: Discussionmentioning

confidence: 99%

First Berlin Heart EXCOR Pediatric VAD Interhospital Transports of Nonambulatory Patients with the Ikus Stationary Driver

Woolley¹,

Dady²,

Spinnato³

et al. 2013

ASAIO Journal

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“…He was transported from Japan to the United States by air and bridged to transplantation after 119 days of support. 25 Since then, the Toyobo LVAS has been the main device for the bridge to transplantation. We have had no other alternatives for long-term support in the majority of patients.…”

Section: Paracorporeal Pulsatile Devicesmentioning

confidence: 99%

Extracorporeal Assist Circulation for Heart Failure

Matsumiya

Saitoh

Sawa

2009

Circ J

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cute cardiogenic shock has a high mortality, irrespective of the original etiology such as myocardial infarction, post-cardiotomy heart failure (HF), acute myocarditis, refractory fatal arrhythmia, and acute decompensation of chronic HF. 1 Rescue with mechanical circulatory support remains the only means of survival in most of these patients. 2 Over the past decade, an increasing number of assist devices have been developed for both temporary and long-term circulatory support. 3 The extended indications, development of better support devices and management strategies, and improved results mandate all cardiology professionals to acquire knowledge of the currently available assist devices. Unfortunately, in Japan only a limited number of devices has been approved for clinical use and limited facilities have a ventricular assist system (VAS) program for long-term use. 4 However, extracorporeal devices for acute HF are readily available for rapid implementation in the most facilities. These first-line devices for acute cardiogenic shock aim at stabilizing the patient's general condition by providing enough systemic circulation and improvement of native heart function to enable eventual removal of the device. If recovery is unlikely, the patients can be transferred to a larger facility with a VAS program for longer term support aiming at either a bridge to transplantation or chronic assistance. 5 Although the number of heart transplantations is severely limited, new modalities for long-term circulatory support, such as permanent therapy using continuous flow implantable VAS, is becoming a reality. 6 Therefore, the short-term support to bridge the patient to these long-term therapies is becoming a more and more important strategy for the treatment of severe HF. Paracorporeal devices were initially developed to support acute HF patients for several weeks to months; 7 however, this type of device has been the only choice as a bridge to transplantation for several years in Japan. 4 Our accumulated experience of chronic support using paracorporeal devices may serve as the foundation data for the more currently utilized devices for long-term use.We review the currently available devices that are placed extracorporeally (non-implantable) for both acute and chronic HF. The indications for use, patient management, and overall results are discussed. Extracorporeal Centrifugal Pump and Membrane OxygenationExtracorporeal life support (ECLS) using a centrifugal pump combined with extracorporeal membrane oxygenation (ECMO) is now considered an important tool for treating acute HF in all age groups, including neonates. 8 In the setting of profound cardiogenic shock or cardiac arrest, ECLS is a viable option for resuscitation and initiating circulatory assist. When venous and arterial cannulas are inserted peripherally, the system is called percutaneous cardiopulmonary support (PCPS). 9 Ready-made systems requiring only few minutes of priming time are commercially available. Various conditions causing cardiogenic shock are indicated ...

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“…Because LVADs are sensitive to blood volume, maintaining adequate hydration and avoidance of caffeinated beverages are important during air travel . Additional fully charged batteries should be accessible during the trip . Medical records and an LVAD card should be available during the security checks.…”

Section: Air Travel and Heart Diseasementioning

confidence: 99%

“…30 Additional fully charged batteries should be accessible during the trip. 32 Medical records and an LVAD card should be available during the security checks. Contacting the airline and airport security should be done prior to the trip.…”

Section: Heart Failurementioning

confidence: 99%

Navigating air travel and cardiovascular concerns: Is the sky the limit?

Hammadah

Kindya

Allard-Ratick

et al. 2017

Clinical Cardiology

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As the population ages and our ability to care for patients with cardiac disease improves, an increasing number of passengers with cardiovascular conditions will be traveling long distances.Many have had cardiac symptoms, recent interventions, devices, or surgery. Air travel is safe for most individuals with stable cardiovascular disease. However, a thorough understanding of the physiologic changes during air travel is essential given the potential impact on cardiovascular health and the risk of complications in passengers with preexisting cardiac conditions. It is important for clinicians to be aware of the current recommendations and precautions that need to be taken before and during air travel for passengers with cardiovascular concerns. | INTRODUCTIONMore than 2.75 billion passengers travel globally by air each year. As the population ages and our ability to care for passengers with cardiac disease improves, an increasing number of people with cardiovascular disease will be utilizing air travel. Among these individuals, some have had pacemakers or automatic defibrillators implanted, recent revascularization, or surgery that might predispose to deep venous thrombosis (DVT). 1-3 Also, the use of air medical transport services provided by private and insurance-affiliated companies has risen significantly over the past 15 years. 4 In the largest observational study of medical emergencies during air travel, which analyzed data of 744 million airline passengers between 2008 and 2010, the medical incidence rate was reported to be 1.6 per 100 000 passengers, with medical deaths occurring in 36 passengers. 3 Cardiac causes represent 8% of the medical emergencies, whereas cardiac arrest was the most common cause of medical death (31/36) and flight diversion. 3,5 Myocardial ischemia is the most common cause of cardiac events during air travel. 6 DVT is another concern for people who fly long distances, with incidence reaching up to 5.4% in high-risk groups flying an average of 12.4 hours. 2 The risk of venous thromboembolism (VTE) is about 3 times higher in passengers on long distance flights than in the general population. 7Air travel is safe for most individuals. Importantly, a thorough understanding of the physiologic changes during air travel is essential for every physician, as special precautions are needed for higher-risk passengers. | PHYSIOLOGICAL CHANGES DURING AIR TRAVELMultiple factors can affect cardiovascular health during air travel, including decreased atmospheric pressure, decreased humidity, gas expansion, prolonged immobility, and increased physical and emotional stress.Most commercial aircraft fly at an elevation somewhere between 22 000 and 44 000 feet above sea level (cruising altitude), with a corresponding decline in partial pressure of inspired oxygen of approximately 4 mm Hg per 1000 feet above sea level. 8 This altitude is associated with an approximate 65% to 85% decrease in atmospheric air pressure and a 60% to 90% decrease in partial pressure of inspired oxygen in comparison with sea lev...

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Overseas transport of a patient with an extracorporeal left ventricular assist device

Cited by 24 publications

References 3 publications

First Berlin Heart EXCOR Pediatric VAD Interhospital Transports of Nonambulatory Patients with the Ikus Stationary Driver

First Berlin Heart EXCOR Pediatric VAD Interhospital Transports of Nonambulatory Patients with the Ikus Stationary Driver

Extracorporeal Assist Circulation for Heart Failure

Navigating air travel and cardiovascular concerns: Is the sky the limit?

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