The European Registry for Patients with Mechanical Circulatory Support (EUROMACS) of the European Association for Cardio-Thoracic Surgery (EACTS): second report

Abstract

Compared to the first EUROMACS report, the number of participating hospitals increased from 21 to 52 (+148%), whereas the number of registered implants more than tripled from 825 to 2947 (+257%). The increase in the number of participating hospitals led us to increase the quality control measures through data input control, on-site audits and statistical analyses.

Clinical Outcome and Comparison of Three Different Left Ventricular Assist Devices in a High‐Risk Cohort

“…The average survival after 30 days and after 1 year is higher in our group than in INTERMACS and EUROMACS registries (10,11), but this has several reasons due to the extremely high preoperative risk in our patients compared to the patient population captured in the INTERMACS registry. Once the cardiac pathology is the leading pathology and other acute comorbidities are controlled, we learned that even those patients could return acceptable results.…”

Heart Replacement Therapy: Biological, Mechanical or Regenerative?

“…For this reason, heart transplantation was almost universally abandoned for at least a decade. The US and non-US governments redirected their research funds toward the development of an implantable LVAD, not as a bridge to transplantation but as a permanently implantable device (4)(5)(6)(7)(8).…”

“…So far, over 60,000 continuous-flow pumps have been implanted worldwide with the aim of bridge to recovery, transplantation or even as permanent support (destination therapy) covering the infant age in pediatrics and the very old age in adults with good outcomes, excellent clinical/surgical versatility, and acceptable durability (4,7,8). This is thanks to the recent and still active research on implantable centrifugal force pumps such as the HeartWare HVAD and the HeartMate III; currently the most implanted pumps (4,7,8).…”

“…However, despite all encouraging results of technology evolution and the current knowledge/management of induced mechanical circulatory support physiology, as above mentioned, the Achilles' heel of implantable mechanical circulatory support devices still remains the absence of a satisfactory biocompatibility with consequent thromboembolic events and the presence of a percutaneous driveline which leads to high risk of infective disorders and represents a real barrier to the long-term application of VADs and TAHs in terms of definitive therapies (4)(5)(6)(7)(8)(9)(10)(11)(12)(13). This is why regenerative medicine has begun to emerge as one of the most promising fields of translational research that has the potential to minimize both the need for, and increase the availability of, donor organs (14)(15)(16)(17)(18)(19).…”

“…Thus, mechanical circulatory support therapy remains the only option whenever available (4). It has improved quality of life and survival rates of patients in endstage heart failure but it is offered to almost 3,000 patients per year only (not routinely due to mostly financial matters), and additionally some patients are even referred for transplant thereafter (4)(5)(6)(7)(8)(9)(10)(11)(20)(21)(22)(23).…”