Prophylactic Intra-Aortic Balloon Pump Before Ventricular Assist Device Implantation Reduces Perioperative Medical Expenses and Improves Postoperative Clinical Course in INTERMACS Profile 2 Patients

Imamura, Teruhiko; Kinugawa, Koichiro; Nitta, Daisuke; Hatano, Masaru; Katoh, Osamu; Nawata, Kan; Kyo, Shunei; Ōno, Minoru

doi:10.1253/circj.cj-15-0122

Cited by 33 publications

(19 citation statements)

References 34 publications

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“…1,2 However, these treatments are often painful and stressful and can depress patients. 3, 4 In Japan, Waon therapy 5-7 has been commonly used to treat such patients for >20 years. It is indicated as Class I for patients with chronic HF in the Japanese guideline.…”

Section: Patient Selectionmentioning

confidence: 99%

Waon Therapy for Managing Chronic Heart Failure　– Results From a Multicenter Prospective Randomized WAON-CHF Study –

Tei

Imamura

Kinugawa

et al. 2016

Circ J

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Background: Waon therapy improves heart failure (HF) symptoms, but further evidence in patients with advanced HF remains uncertain. Methods and Results:In 19 institutes, we prospectively enrolled hospitalized patients with advanced HF, who had plasma levels of B-type natriuretic peptide (BNP) >500 pg/ml on admission and BNP >300 pg/ml regardless of more than 1 week of medical therapy. Enrolled patients were randomized into Waon therapy or control groups. Waon therapy was performed once daily for 10 days with a far infrared-ray dry sauna maintained at 60°C for 15 min, followed by bed rest for 30 min covered with a blanket. The primary endpoint was the ratio of BNP before and after treatment. In total, 76 Waon therapy and 73 control patients (mean age 66 years, men 61%, mean plasma BNP 777 pg/ml) were studied. The groups differed only in body mass index and the frequency of diabetes. The plasma BNP, NYHA classification, 6-min walk distance (6MWD), and cardiothoracic ratio significantly improved only in the Waon therapy group. Improvements in NYHA classification, 6MWD, and cardiothoracic ratio were significant in the Waon therapy group, although the change in plasma BNP did not reach statistical significance. No serious adverse events were observed in either group. Conclusions:Waon therapy, a holistic soothing warmth therapy, showed clinical advantages in safety and efficacy among patients with advanced HF. (Circ J 2016; 80: 827 -834)

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Section: Patient Selectionmentioning

confidence: 99%

Waon Therapy for Managing Chronic Heart Failure　– Results From a Multicenter Prospective Randomized WAON-CHF Study –

Tei

Imamura

Kinugawa

et al. 2016

Circ J

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“…Recovery of end-organ function is beneficial even in patients who undergo VAD implantation, because it improves the post-VAD prognosis. 28,30) Long-term prognosis relating to cardiac replacement therapy: Previous studies showed the prognosis of ASV therapy by assessing the surrogate markers during a short-or midterm study period (< 1 year), whereas we showed the advantage of ASV therapy in terms of 2-year survival rate and VADfree survival rate. Considering the hazard ratio of 2.067 for continuous ASV therapy in relation to the 2-year VAD-free survival rate, ASV therapy seems to be effective from the viewpoint of delaying the timing of VAD implantation.…”

Section: Discussionmentioning

confidence: 69%

Long-Term Adaptive Servo-Ventilator Treatment Prevents Cardiac Death and Improves Clinical Outcome

et al. 2016

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SummaryAdaptive servo-ventilation (ASV) is a recently developed, noninvasive therapeutic tool for the treatment of heart failure (HF). However, the efficacy of ASV therapy in patients with advanced HF remains uncertain, especially as regards its contribution to freedom from cardiac replacement therapy. A total of 85 patients with advanced HF (New York Heart Association [NYHA] class IV 71%, inotrope infusion-dependent 34%) refractory to guideline-directed medical therapy, received ASV therapy, irrespective of sleep-disordered breathing, at our institute between 2008 and 2014. Among these 85 patients, 46 continued ASV therapy for > 1 month (continued group), whereas 39 discontinued the therapy after < 1 month because of intolerance (discontinued group). There were no significant differences in baseline variables between the two groups. Heart rate indicating sympathetic activity, left ventricular (LV) reverse remodeling assessed by LV diastolic diameter, LV ejection fraction, and the grades of mitral and tricuspid regurgitations, HF severity assessed by NYHA class and plasma level of B-type natriuretic peptide, and end-organ dysfunction, improved significantly at 6 months following the initiation of ASV therapy (P < 0.05 for all). All-cause mortality and cardiac death rate were significantly lower during 2-year follow up in the continued group (P < 0.05 for both). In conclusion, ASV is a novel therapeutic tool prior to cardiac replacement therapy in patients with advanced HF and may prolong the period until cardiac replacement therapy becomes necessary. (Int Heart J 2016; 57: 47-52)

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“…The use of preoperative IABP in high-risk patients reduces the length of hospital stay compared to patients with IABP installed after surgery or when unused [11] [13]- [15]. The length of stay for this study is within of the average found in the literature.…”

Section: Discussionmentioning

confidence: 81%

“…On this study, the good postoperative evolution, joint by LVEF improvement and LVDD reduction, although without statistical relevance, suggests that there is benefit in the strategy that link preoperative IABP and myocardium revascularization, even though it cannot be disposed that the hemodynamic improvement occurred only by revascularization. Last year, some studies observed that the mortality of the patients who received IABP in the preoperative of the myocardium revascularization surgery was 13.6%, while the mortality in patients who received the balloon in the trans or post-operative was, approximately, 35% [15]- [17].…”

Section: Discussionmentioning

confidence: 99%

Preoperative Intra-Aortic Balloon Counterpulsation in Coronary Artery Bypass Graft Patients with Severe Left Ventricular Dysfunction

Freitas¹,

Gurian²,

Saporito³

et al. 2016

WJCD

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Background: The intra-aortic balloon pumping (IABP) is the most used ventricular mechanical assist device. In recent years, the preoperative use in patients with severe ventricular dysfunction presents itself as a great benefic strategy to the postoperative recovery. This paper aim is to evaluate the IABP post-operative benefit in patients with severe ventricular dysfunction. Methods: From January 2011 to March 2016, 125 patients underwent a coronary artery bypass graft (CABG) with cardiopulmonary bypass and preoperative IABP in Teaching Hospital of the ABC Medical School and Hospital Estadual Mario Covas. The inclusion criteria were the presence of severe ischemic cardiomyopathy with left ventricular ejection fraction (LVEF) less than or equal to 40%, estimated by Doppler echocardiography using the Simpson method. The preoperative LVEF was 30.25% ± 8.53% and the diastolic diameter of the left ventricle (LVDD) 67.75 ± 16.37 mm. IABP was installed approximately 15 hours before the surgery. Results: The patients required the IABP for 2.4 ± 1.58 days, and vasoactive drugs, 4.8 ± 2.12 days. We performed 3.2 ± 1.9 grafts per patient and the total length of stay was 07 ± 5.52 days. Cardiopulmonary bypass time was 67 ± 10.95 minutes and anoxia time, 46.4 ± 10.06 minutes. Twelve patients (9.6%) had pneumonia and four (3.2%), atrial fibrillation. We observed a LVDD reduction to 63 ± 16.26 (p = 0.068) and LVEF enhancement to 36.50 ± 16.86 (p = 0.144). The data were analyzed statistically according to the Wilcoxon test. There were no deaths. Conclusion: The initial experience of the authors with the preoperative IABP in patients with severe left ventricular dysfunction suggests great benefit in post-operative recovery with improvement of LVEF and reduction of LVDD.

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Prophylactic Intra-Aortic Balloon Pump Before Ventricular Assist Device Implantation Reduces Perioperative Medical Expenses and Improves Postoperative Clinical Course in INTERMACS Profile 2 Patients

Cited by 33 publications

References 34 publications

Waon Therapy for Managing Chronic Heart Failure　– Results From a Multicenter Prospective Randomized WAON-CHF Study –

Waon Therapy for Managing Chronic Heart Failure　– Results From a Multicenter Prospective Randomized WAON-CHF Study –

Long-Term Adaptive Servo-Ventilator Treatment Prevents Cardiac Death and Improves Clinical Outcome

Preoperative Intra-Aortic Balloon Counterpulsation in Coronary Artery Bypass Graft Patients with Severe Left Ventricular Dysfunction

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Prophylactic Intra-Aortic Balloon Pump Before Ventricular Assist Device Implantation Reduces Perioperative Medical Expenses and Improves Postoperative Clinical Course in INTERMACS Profile 2 Patients

Cited by 33 publications

References 34 publications

Waon Therapy for Managing Chronic Heart Failure – Results From a Multicenter Prospective Randomized WAON-CHF Study –

Waon Therapy for Managing Chronic Heart Failure – Results From a Multicenter Prospective Randomized WAON-CHF Study –

Long-Term Adaptive Servo-Ventilator Treatment Prevents Cardiac Death and Improves Clinical Outcome

Preoperative Intra-Aortic Balloon Counterpulsation in Coronary Artery Bypass Graft Patients with Severe Left Ventricular Dysfunction

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Waon Therapy for Managing Chronic Heart Failure　– Results From a Multicenter Prospective Randomized WAON-CHF Study –

Waon Therapy for Managing Chronic Heart Failure　– Results From a Multicenter Prospective Randomized WAON-CHF Study –