Temporary Mechanical Circulatory Support as a Bridge to Heart Transplant or Durable Left Ventricular Assist Device

Arora, Sonali; Atreya, Auras R.; Birati, Edo Y.; Shore, Supriya

doi:10.1016/j.iccl.2020.12.011

Cited by 3 publications

(4 citation statements)

References 33 publications

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Section: Oxygen Therapy In Heart Failurementioning

confidence: 99%

“…These temporary mechanical circulatory support devices are also useful as a bridge to long-term mechanical circulatory support or heart transplant in end-stage HF with refractory cardiogenic shock (Figure 2). 19 HF patients who also have concomitant chronic obstructive pulmonary disease (COPD) are at risk of hypercapnic respiratory failure. High concentrations of oxygen in these patients can cause progressive hypercarbia.…”

Section: Mechanism Of Hypoxia In Heart Failurementioning

confidence: 99%

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Oxygen Management in Heart Failure Patients

Ramachandran

Prasad

Garre

et al. 2022

Indian Journal of Clinical Cardiology

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Symptoms of heart failure (HF) should be alleviated as quickly as feasible. Apart from standard pharmacological therapy, supplementation of oxygen is lifesaving in hypoxemic (SpO2 <90% or PaO2 <60 mmHg) HF patients. For sick patients with SpO2 <85%, respiratory distress (respiratory rate >25 breaths per min) and pulmonary edema, along with oxygen administration, noninvasive positive pressure ventilation (NIPPV) methods, including BiPAP/CPAP or humidified high-flow nasal oxygen, should be tried to optimize oxygenation, reduce work of breathing and to reduce the venous return. If these noninvasive ventilatory support methods fail to improve hypoxemia, endotracheal intubation and mechanical ventilation should be instituted. Short-term mechanical circulatory support (extracorporeal membrane oxygenation) devices are reserved for cardiogenic shock patients due to advanced HF associated with reversible end-organ failure and hypoxia. These temporary mechanical circulatory support devices are also useful as a bridge to long-term mechanical circulatory support or heart transplant in end-stage HF with refractory cardiogenic shock. Even though the use of additional oxygen is a standard practice for hypoxemic patients, routine use of high concentrations of oxygen via inhalational therapy or NIPPV for normoxemic HF patients may result in hyperoxemia. Hyperoxemia has been shown to have negative hemodynamic effects like increased systemic vascular resistance, reduced cardiac index, and decreased coronary blood flow. Detailed prescription by the treating physician, careful monitoring, and meticulous titration of oxygen is essential for safe oxygen treatment for HF patients.

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Section: Oxygen Therapy In Heart Failurementioning

confidence: 99%

Section: Mechanism Of Hypoxia In Heart Failurementioning

confidence: 99%

Oxygen Management in Heart Failure Patients

Ramachandran

Prasad

Garre

et al. 2022

Indian Journal of Clinical Cardiology

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“…Temporary mechanical circulatory support may be needed for LV or RV dysfunction and allows the donor heart to recover from dysfunctional state and serves to salvage the heart transplantation. 33,34 The goal of long-term post-transplantation follow-up protocols is to ensure cardiac graft function and early detection of complications (graft rejection and CAV) and the adverse effects that stem from prolonged immunosuppressive therapy (infection, hypertension, diabetes, chronic kidney disease, malignancy). To this effect, in the early posttransplant phase, endomyocardial biopsies are performed routinely to detect cellular rejection (weekly in the first month, every 2 weeks in the 2nd month, monthly until 6 months, and then the 9th month and 12th month posttransplant).…”

Section: Post Transplantation Follow-up and Managementmentioning

confidence: 99%

Section: Section Ii: Pre- and Post-heart Transplant Managementmentioning

confidence: 99%

Current Status of Cardiac Transplantation in the 21st Century

Arora

Attawar

2021

Indian Journal of Clinical Cardiology

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Advanced heart failure is an entity where irreversible structural heart disease is associated with persistent, refractory symptoms and quantitative decrease in cardiopulmonary capacity. Despite advanced and comprehensive medical therapy, patients are at high risk of death due to cardiogenic shock or cardiac arrest. Heart transplantation was developed as a surgical intervention to replace the failing recipient heart with a healthy heart from a recently deceased donor. In this article, we discuss the current state of cardiac transplantation, more than 5 decades after the first human cardiac transplantation was performed. Apart from an historical overview of the development of surgical techniques, we focus on appropriate patient selection, pretransplant evaluation, and recognition and treatment of post-transplant complications.

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The novel ProtekDuo ventricular assist device: Configurations, technical aspects, and present evidence

et al. 2022

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The ProtekDuo, single site dual lumen cannula can be used in a multitude of configurations. In the medical literature, the ProtekDuo is described as right ventricular assist device (RVAD), as left ventricular assist device (LVAD), as biventricular assist device (BiVAD) when combined with an Impella device or other LVAD’s, as double lumen drainage cannula on cardiopulmonary bypass (CPB), as RVAD with oxygenator, in veno-pulmonary (V-P) ECMO configuration, venovenous-pulmonary (VV-P) ECMO configuration with additional drainage cannula, and in veno-venopulmonary (V-VP) ECMO configuration as double lumen return cannula. Improvements in flow and oxygenation have been recognized in various settings and need further scientific evaluation. We summarized the above-mentioned configurations, technical aspects, and the present literature available for the ProtekDuo.

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Temporary Mechanical Circulatory Support as a Bridge to Heart Transplant or Durable Left Ventricular Assist Device

Cited by 3 publications

References 33 publications

Oxygen Management in Heart Failure Patients

Oxygen Management in Heart Failure Patients

Current Status of Cardiac Transplantation in the 21st Century

The novel ProtekDuo ventricular assist device: Configurations, technical aspects, and present evidence

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