Results of Mechanical Ventricular Assistance for the Treatment of Post Cardiotomy Cardiogenic Shock

Mehta, Sanjay M; Aufiero, Thomas X.; Pae, Walter E.; Miller, Cynthia A.; Pierce, William S.

doi:10.1097/00002480-199642030-00019

Cited by 17 publications

(22 citation statements)

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“…Despite inotropic drugs, intubation and control of cardiac rhythm, certain patients remain hemodynamically unstable and refractory to medical therapy, thereby requiring mechanical circulatory support. [8,9] To date, various devices such as the Levitronix CentriMag VAD have been developed and approved for acute circulatory support. Unlike the longer-term devices designed for prolonged use as bridge to transplantation, these devices are more suitable for the acute resuscitative phase.…”

Section: Discussionmentioning

confidence: 99%

The Levitronix CentriMag ventricular assist device as a bridge to decision in patients with end-stage heart failure: Our single-center experience

Rabuş¹

2017

Turk Gogus Kalp Dama

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Rabuş MB, Salihi S, Hasanov S, Fedakar A, Çevirme D, Balkanay M. The Levitronix CentriMag ventricular assist device as a bridge to decision in patients with end-stage heart failure: Our single-center experience. Turk Gogus Kalp Dama 2017;25(4):543-9. ABSTRACTBackground: In this study, we report early outcomes of Levitronix CentriMag device implantation for bridge to decision for patients with end-stage heart failure in a single center.

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Section: Discussionmentioning

confidence: 99%

The Levitronix CentriMag ventricular assist device as a bridge to decision in patients with end-stage heart failure: Our single-center experience

Rabuş¹

2017

Turk Gogus Kalp Dama

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“…From the combined registry report of mechanical ventricular assistance after cardiac operation ( 10), the weaning and discharge rates were 45.7% and 25.3%, respectively. A similar outcome was reported from the Japanese registry for the clinical use of ventricular assist devices ( 11).…”

Section: Discussionmentioning

confidence: 99%

“…Although the current results of open heart operations have been improved due to standardized surgical techniques, precise myocardial protection, advanced CPB support, and so forth, about 1% of patients who have undergone cardiovascular operations have shown postcardiotomy ventricular failure despite IABP and inotropic supports, and they have required circulatory support (3,8,10). From our experience, 65 (1.4%) of 4,500 adult patients following cardiovascular operations on CPB underwent circulatory support for severe cardiac failure and/or fatal ventricular arrhythmia.…”

Section: Discussionmentioning

confidence: 99%

Clinical Experience of Left Ventricular Assist Systems at The Heart Institute of Japan

et al. 1999

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The main indications for left ventricular assist system (LVAS) support are postcardiotomy ventricular failure as temporary circulatory support and end-stage cardiomyopathy as chronic circulatory support. To clarify the efficacy of LVAS support, we assessed the clinical outcome of a pneumatic LVAS and an electromagnetic LVAS for patients with severe ventricular failure. As of March 1998, 5 patients with postcardiotomy ventricular failure had received the pneumatic LVAS support, and 2 other patients with end-stage idiopathic cardiomyopathy had undergone implantation of the electromagnetic LVAS. The drive control of the LVAS was mainly counterpulsation in the diastole of the native heart. In the 5 postcardiotomy patients, the duration of pneumatic LVAS support ranged from 30 to 312 h (mean, 109.2). All 3 patients with more than 72 h support were successfully weaned, and 2 of them survived. The other 2 patients with cardiogenic shock and less than 36 h support could not be weaned from the LVAS. In the 2 cardiomyopathy patients, 1 patient was well maintained by the electromagnetic LVAS support and underwent successful heart transplantation 7 months later. The other patient has been chronically supported by the LVAS for 2 months and is doing well so far. These results suggest that selective application of the pneumatic LVAS as a temporary support and the electromagnetic LVAS as a chronic support might be appropriate for maximizing the effectiveness of LVAS treatment for profound cardiac failure.

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“…The clinical application of PCPS (2–4) includes elective circulatory support during high‐risk coronary interventions, resuscitative use for patients with cardiogenic shock mainly due to myocardial infarction, myocarditis, pulmonary embolism, cardiopulmonary arrest (CPA) for any reason in the emergency room, and postcardiotomy low cardiac output syndrome (LOS). The results of elective use for high‐risk coronary interventions are favorable (2,5), but the reported outcomes of the emergency use of PCPS have been unsatisfactory in several series (3,6–12). It has been reported that postcardiotomy cardiogenic shock occurs in 2–6% of patients undergoing revascularization and valvular procedures, and approximately 1% or less will require advanced mechanical assistance other than the intraaortic balloon pump (IABP) (8).…”

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confidence: 99%

Outcome of the Perioperative Use of Percutaneous Cardiopulmonary Support for Adult Cardiac Surgery: Factors Affecting Hospital Mortality

Murashita¹,

Eya²,

Miyatake³

et al. 2004

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Percutaneous cardiopulmonary bypass support (PCPS) has become a widespread standard modality for the treatment of circulatory collapse; however, its clinical use for postcardiotomy low cardiac output syndrome (LOS) has been reported to be unsatisfactory. We reviewed the clinical outcomes of twenty-three patients undergoing cardiac surgery and treated with PCPS. Solitary coronary artery grafting was undertaken for nine patients, while three had concomitant procedures. The remaining patients underwent valvular surgery. The indications for PCPS were preoperative shock in two patients and postcardiotomy LOS or shock in twenty-one patients. All patients except one underwent an intraaortic balloon pump. Sixteen of the twenty-three patients (69.6%) were weaned from PCPS and twelve patients (52.2%) reached hospital discharge. A univariate analysis revealed that risk factors for hospital mortality were age older than seventy years (P = 0.05), PCPS running time (P = 0.017), low cardiac function at the institution of PCPS (P = 0.004), and urine output within the initial 24 h (P = 0.041). The cardiac index (CI) in survivors was improved within 24 h, and eleven of the twelve survivors were weaned off PCPS within 48 h, whereas ten of the twelve nonsurvivors required PCPS for more than 48 h (P = 0.0006). There is little possibility of weaning patients from PCPS who do not show any signs of hemodynamic recovery within 48 h after its institution. Limited use of PCPS within 48 h may be applicable for postcardiotomy patients, but other cardiopulmonary support, such as a left ventricular assist device, may be required when hemodynamic recovery is not obtained within 48 h.

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Results of Mechanical Ventricular Assistance for the Treatment of Post Cardiotomy Cardiogenic Shock

Cited by 17 publications

References 0 publications

The Levitronix CentriMag ventricular assist device as a bridge to decision in patients with end-stage heart failure: Our single-center experience

The Levitronix CentriMag ventricular assist device as a bridge to decision in patients with end-stage heart failure: Our single-center experience

Clinical Experience of Left Ventricular Assist Systems at The Heart Institute of Japan

Outcome of the Perioperative Use of Percutaneous Cardiopulmonary Support for Adult Cardiac Surgery: Factors Affecting Hospital Mortality

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