Prompt ECLS support is an effective strategy and provides a reasonable chance of survival in patients with AMI associated with profound CS. As shown in our results pertaining to predictive risk factors for 30-day mortality, reducing the duration of end-organ ischaemia is the keystone to management of this patient population. A major remaining challenge will consist in preventing pulmonary oedema following peripheral ECLS.
Implantation of a long-term MCS device in patients on ECLS can result in severe ALI, which is associated with ominous outcomes. Various preimplant risk factors for ALI have been identified and might allow devising strategies to prevent this complication.
21Objectives. Implantable left ventricular assist device (LVAD) is a major therapeutic progress 22 for end-stage heart failure in selected patients. As their use is expanding, infectious 23 complications are emerging, with limited data available to guide their management. We 24 aimed to better characterize LVAD-related infections.
25Methods. We enrolled all consecutive patients diagnosed with LVAD-related infections in 3 26 referral centers in France, using standardized definition of infections in patients with LVAD.
27Data were collected from medical charts using a standardized questionnaire. with the use of prolonged antibacterial treatment in 34 (94%), and debridement in 17 (47%).
40One patient died due to LVAD-associated infection.
41Conclusions. LVAD-related infections are common after LVAD implantation, and may be 42 controlled by prolonged antibiotic treatment.
Despite the morbidity and mortality occurring during the postimplantation period, home discharge with a TAH is possible. Portables drivers allow for a safe return home. Aside from some remaining weak points such as infectious complications or noise, CardioWest TAH allows for successful rehabilitation of graft candidates, and assures highly satisfactory transplant results.
Despite its simplicity, the CARE score predicts mortality and major morbidity as well the EuroSCORE. In addition, it remains devoid of significant variability when used by groups of physicians of different specialties.
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