2013
DOI: 10.1161/circheartfailure.112.000237
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Preoperative INTERMACS Profiles Determine Postoperative Outcomes in Critically Ill Patients Undergoing Emergency Heart Transplantation

Abstract: Background— Postoperative outcomes of patients with advanced heart failure undergoing ventricular assist device implantation are strongly influenced by their preoperative Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profiles. We sought to investigate whether a similar association exists in patients undergoing emergency heart transplantation. Methods and Results— By means of the Spanish National Heart Tran… Show more

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Cited by 66 publications
(64 citation statements)
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References 26 publications
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“…This finding indicates that VAD implantation should be performed before respiratory distress and RV failure occur, which may lead to increased bilirubin levels and is in accordance with that of Stein et al [11]. The MCS initiation threshold has been lowered in adults based on INTERMACS data and the current recommendation for MCS is a profile rating of 2 or 3 to reduce co-morbidity and improve outcomes [10]. Indeed, in the present study, all patients who died were INTERMACS profile-1 at the time of VAD implantation whereas patients who received HTx were initiated at profile-2.…”
Section: Discussionsupporting
confidence: 78%
See 1 more Smart Citation
“…This finding indicates that VAD implantation should be performed before respiratory distress and RV failure occur, which may lead to increased bilirubin levels and is in accordance with that of Stein et al [11]. The MCS initiation threshold has been lowered in adults based on INTERMACS data and the current recommendation for MCS is a profile rating of 2 or 3 to reduce co-morbidity and improve outcomes [10]. Indeed, in the present study, all patients who died were INTERMACS profile-1 at the time of VAD implantation whereas patients who received HTx were initiated at profile-2.…”
Section: Discussionsupporting
confidence: 78%
“…Preoperative clinical conditions were evaluated based on INTERMACS patient profiles [10]. Preoperative INTERMACS profiles, type of VADs, preoperative need for mechanical ventilation, duration of support, complications during MCS, and outcomes were recorded.…”
Section: Data Collectionmentioning
confidence: 99%
“…Chronic renal dysfunction was defined as the presence of a serum creatinine level 42 mg/dl at least for 3 months before HT. The term "emergency HT" refers to the highest level of waiting list priority ("status 0"), according to the criteria of the organ donor allocation system in Spain, 19 which requires the presence of refractory heart failure depending on mechanical circulatory support or intravenous inotropes, together with mechanical ventilation, or complicated with refractory recurrent ventricular arrhythmia.…”
Section: Data Collection and Definition Of Variablesmentioning
confidence: 99%
“…De-oxygenated blood study investigated the determinants of postoperative outcome in patients treated with LVAD and HTX [35][36][37][38][39] and now provides us with a tool to stratify patients based on postoperative prognosis after LVAD implantation or HTX [35][36][37][38][39].…”
Section: Internal Jugular Veinmentioning
confidence: 99%
“…The INTERMACS scale was developed to assign patients with advanced HF into seven levels according to hemodynamic profile and level of target organ damage (TABLE 1) [35][36][37][38][39]. This classification was defined in the context of a multicenter registry of ventricular assist devices, with the objective of unifying criteria to describe the clinical state of advanced HF patients, optimizing perioperative risk prediction and clarifying the instructions for each of the available alternative treatments [35][36][37][38][39].…”
Section: Internal Jugular Veinmentioning
confidence: 99%