Results of mechanical circulatory support in France

Mazzucotelli, Jean‐Philippe; Leprince, Pascal; Litzler, Pierre‐Yves; Vincentelli, André; Guyader, Alexandre Le; Kirsch, Matthias; Camilleri, Lionel; Flécher, Erwan

doi:10.1016/j.ejcts.2011.04.005

Cited by 14 publications

(11 citation statements)

References 18 publications

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“…However, our finding corroborates that of the national French GRAM registry (Groupe de R eflexion sur l'Assistance M ecanique), which showed that among 520 mechanical circulatory support recipients implanted in France between 2000 and 2006, 73% underwent biventricular support [7]. One potential explanation is that many recipients were referred too late, once the patient was in severe cardiogenic shock with multiorgan dysfunction, thus precluding safe isolated left ventricular support.…”

Section: Commentsupporting

confidence: 89%

SynCardia Temporary Total Artificial Heart as Bridge to Transplantation: Current Results at La Pitié Hospital

Kirsch

Nguyen

Mastroianni

et al. 2013

The Annals of Thoracic Surgery

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Section: Commentsupporting

confidence: 89%

SynCardia Temporary Total Artificial Heart as Bridge to Transplantation: Current Results at La Pitié Hospital

Kirsch

Nguyen

Mastroianni

et al. 2013

The Annals of Thoracic Surgery

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“…Furthermore, the TAH compares favourably with BiVAD devices in terms of early/mid-term survival or stroke. 4,17,18 This is likely because of the complete removal of both ventricles, the absence of residual thrombi and the use of shorter drivelines with large-diameter cannula. Also, local antithrombotic management could be associated with those low rates of neurologic events.…”

Section: Survival After Transplantationmentioning

confidence: 99%

Experience with the SynCardia total artificial heart in a Canadian centre

Nguyen

Pellerin

Perrault

et al. 2017

CJS

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Background:The SynCardia total artificial heart (TAH) provides complete circulatory support by replacing both native ventricles. Accepted indications include bridge to transplantation and destination therapy. We review our experience with TAH implantation during a period when axial flow pump became available. Methods:We retrospectively analyzed the demographics, clinical characteristics and survival of all patients receiving the TAH. Results:From September 2004 to November 2016, 13 patients (12 men, mean age 45 ± 13 yr) received the TAH for refractory cardiogenic shock secondary to idiopathic (56%) or ischemic (17%) cardiomyopathy and to other various causes (33%). Before implantation, mean ejection fraction was 14% ± 4%, 7 (54%) patients had previous cardiac surgery, 4 (31%) were on mechanical ventilation, and 3 (23%) patients were on dialysis. The mean duration of TAH support was 46 ± 40 days. Three (23%) patients died while on support after a mean of 15 days. Actuarial survival on support was 77% ± 12% at 30 days after implantation. Complications on support included stroke (n = 1, 8%), acute respiratory distress syndrome requiring prolonged intubation (n = 5, 38%) and acute renal failure requiring temporary dialysis (n = 5, 38%). Ten (77%) patients survived to be transplanted after a mean of 52 ± 42 days of support. Actuarial survival rates after transplant were 67% ± 16% at 1 month and 56% ± 17% at 1 year after transplantation. Conclusion:The TAH provides an alternative with low incidence of neurologic events in extremely fragile and complex patients waiting for heart transplantation. Complex and unusual anatomic conditions explained the current use of TAH.

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“…The use of ECMO has been described in neonates, infants and adults in the setting of incessant arrhythmias leading to progressive severe cardiogenic shock (18)(19)(20)(21). VA ECMO provides vital organ perfusion and permits medical treatment in the setting of cardiogenic shock from refractory VT (22,23).…”

Section: Therapeutic Options For Vtmentioning

confidence: 99%

Extracorporeal life support for refractory ventricular tachycardia

et al. 2017

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Extracorporeal life support (ECLS) is a very effective bridging therapy in patients with refractory ventricular tachycardia (VT) associated with cardiogenic shock. A moribund patient in extremis, is not amenable to optimization by standard ACC/AHA guidelines. New approaches and novel salvage techniques are necessary to improve outcomes in patients with refractory clinical settings such as malignant ventricular arrhythmias, cardiac arrest, cardiogenic shock and/or pulmonary failure until further management options are explored. Data base searches were done using key words such as ECLS, VT, cardiac arrest, VT ablation, venoarterial extra-corporeal membrane oxygenation (VA-ECMO). The use of ECLS has been described in a few case reports to facilitate VT ablation for incessant VT refractory to medical therapy. For patients with, out-of- hospital ventricular fibrillation (VF) and VT, Minnesota Resuscitation Consortium has implemented emergent advanced perfusion and reperfusion strategy, followed by coronary angiography and primary coronary intervention to improve outcome. The major indications for ECLS are cardiogenic shock related to acute myocardial infarction, myocarditis, post embolic acute cor pulmonale, drug intoxication and post cardiac arrest syndrome with the threat of multi-organ failure. ECLS permits the use of negative inotropic antiarrhythmic drug therapy, facilitates the weaning of catecholamine administration, thereby ending the vicious cycle of catecholamine driven electric storm. ECLS provides hemodynamic support during ablation procedure, while mapping and induction of VT is undertaken. ECLS provides early access to cardiac catheterization laboratory in patients with cardiac arrest due to shockable rhythm. The current evidence from literature, supports the use of ECLS to ensure adequate vital organ perfusion in patients with refractory VT. ECLS is a safe, feasible and effective therapeutic option when conventional therapies are insufficient to support cardiopulmonary function. A highly driven multidisciplinary team approach is essential to accomplish this task.

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Results of mechanical circulatory support in France

Abstract: MCS is an essential therapeutic tool to save the life of young patients with cardiogenic shock or advanced cardiac failure. Early MCS implantation and the availability of a device that is adapted to the patient's clinical status are prerequisites for reducing overall mortality rates.

Cited by 14 publications

References 18 publications

SynCardia Temporary Total Artificial Heart as Bridge to Transplantation: Current Results at La Pitié Hospital

SynCardia Temporary Total Artificial Heart as Bridge to Transplantation: Current Results at La Pitié Hospital

Experience with the SynCardia total artificial heart in a Canadian centre

Extracorporeal life support for refractory ventricular tachycardia

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