Pregledni rad
Take the Best – How to Choose the Rig ht Device?
Stephan W. Hirt
; Department of Cardiothoracic Surgery, University Medical Centre, Regensburg, Germany
Christof Schmid
; Department of Cardiothoracic Surgery, University Medical Centre, Regensburg, Germany
Sažetak
An increasing number of patients suffering from end-stage heart failure require VAD implantation as either a bridge-to-transplantation or destination therapy. The choice of the right device depends upon the medical urgency; the need of uni- or biventricular support; the duration of support expected; and the institutional availability. Patients with multi-organ failure and unclear neurological situation can be supported with rotary pumps/ECMO first, and in case of recovery, a paracorporeal system can be connected to the previously implanted cannulas. In stable patients qualifying for left ventricular support, an intracorporeal system of the second generation can be implanted, allowing freedom of movement for 6-8 hours before recharging becomes necessary, and support intervals exceeding 1 year. Restrictions are given by the need of high-dose anticoagulation and a certain complication rate, especially in the first 3 months (bleeding, thromboembolism, infection, mechanical failure). The survival rate after the primary LVAD implantation is 74 % after 12 months and 55 % after 24 months; this is significantly better than the survival rate after RVAD, BVAD or TAH.
Ključne riječi
cardiac failure; mechanical assist device; heart transplantation
Hrčak ID:
66343
URI
Datum izdavanja:
11.3.2011.
Posjeta: 1.599 *