Use of a Prosthetic Ventricle as a Bridge to Cardiac Transplantation for Postinfarction Cardiogenic Shock

Hill, J. Donald; Farrar, David J.; Hershon, J J; Compton, Peter; Avery, Gretchen; Levin, Bertram; Brent, Bruce N.

doi:10.1056/nejm198603063141007

Cited by 132 publications

(15 citation statements)

References 7 publications

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“…These devices, which have been shown to increase survival and improve quality of life [1, 2], can be used as a bridge to heart transplantation or serve as destination therapy for patients who are not appropriate transplant candidates [3–5]. MCS therapy utilizing VADs has revolutionized the management of end-stage heart failure and provides life-saving therapy to many patients awaiting heart transplantation or those who are suboptimum candidates.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Findings and Clinical Outcomes in Ventricular Assist Device Recipients with Gastrointestinal Bleeding

et al. 2011

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Background Gastrointestinal bleeding (GIB) is an important clinical problem in recipients of ventricular assist devices (VAD), although data pertaining to the endoscopic evaluation and management of this complication are limited in the medical literature. Aims We sought to identify the most common endoscopic findings in VAD recipients with GIB, and to better define the diagnostic and therapeutic utility of endosopy for this patient population. Methods Twenty-six subjects with VAD and overt GIB were retrospectively identified. Clinical and endoscopic data were abstracted for each subject on to standardized forms in duplicate and independent fashion. Raw data and descriptive statistics were reported. Results Non-peptic vascular lesions were the most common cause of GIB. A definitive cause of bleeding was identified by endoscopy in almost 60% of subjects. Endoscopic hemostasis was achieved in 14/15 patients in whom bleeding did not stop spontaneously. Rebleeding occurred in 50% of subjects and was successfully retreated or stopped spontaneously in all cases. Colonoscopy did not establish a definitive diagnosis or deliver hemostatic therapy in any case. Conclusions Vascular malformations account for the overwhelming majority of bleeding lesions in VAD patients with GIB. Endoscopy seems to be a safe and effective tool for diagnosing, risk stratifying, and treating this patient population, although multiple endoscopies may be necessary before therapeutic success, and the incidence of rebleeding is high. A prospective multi-center registry is necessary to establish evidence-based management algorithms for VAD recipients with GIB.

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Section: Introductionmentioning

confidence: 99%

Endoscopic Findings and Clinical Outcomes in Ventricular Assist Device Recipients with Gastrointestinal Bleeding

et al. 2011

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“…The recognition of the paucity of donor hearts relative to the number of end-stage heart failure patients led scientists and medical device companies to work aggressively to develop VADs. In 1984, Portner and colleagues at Stanford University (CA, USA) and Hill at California Pacific Medical Center (CA, USA) were the first to report a successful cardiac transplant with the use of an LVAD as a bridge [10,17,18]. This success helped to solidify the field of mechanical circulatory support as a treatment option for advanced heart failure [19].…”

Section: History and Evolution Of Ventricular Assist Device Therapymentioning

confidence: 99%

HeartMate^®II continuous-flow left ventricular assist system

Sheikh

Russell

2011

Expert Review of Medical Devices

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Left ventricular assist devices (LVADs) have emerged as a beneficial therapeutic strategy proven to improve the morbidity and mortality of patients with advanced heart failure. Continuous-flow rotary LVADs have been developed in the hopes of delivering circulatory support in a more durable manner with fewer device-related complications. The HeartMate(®) II continuous-flow left ventricular assist system (LVAS; Thoratec Corporation, Pleasanton, CA, USA) has become the standard of care for heart failure patients who require long-term mechanical circulatory support. The efficacy of the HeartMate II has been demonstrated in patients where temporary support with an LVAD is needed until a suitable donor organ can be found for transplant (termed 'bridge to transplantation'), as well as for terminally-ill heart failure patients who are not candidates for transplant ('destination therapy'). When directly compared with a pulsatile LVAD, the implantation of a HeartMate II LVAS resulted in an overall improvement in survival with a reduction in the number of device-related complications and adverse events. The purpose of this article is threefold: to describe the history of the development of continuous-flow LVADs; to describe the technology of the HeartMate II; and, finally, to review the clinical outcomes in patients who have been implanted with the device.

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“…This was followed by the Pearce-Donachey paracorporeal pneumatic VAD system (8) and in 1992 the successful bridging with the implantable pneumatic HeartMate VAD (ThermoCardiosystems Thoratec, Pleasantson, CA) (9). Despite the clinical focus on bridging therapy to transplantation, the circulatory support scientific community was clearly targeting the development of devices capable of long-term circulatory support.…”

Section: Developmental History Of Mechanical Circulatory Supportmentioning

confidence: 99%

Mechanical Circulatory Support

Kirklin

Naftel

2008

Circ: Heart Failure

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Use of a Prosthetic Ventricle as a Bridge to Cardiac Transplantation for Postinfarction Cardiogenic Shock

Cited by 132 publications

References 7 publications

Endoscopic Findings and Clinical Outcomes in Ventricular Assist Device Recipients with Gastrointestinal Bleeding

Endoscopic Findings and Clinical Outcomes in Ventricular Assist Device Recipients with Gastrointestinal Bleeding

HeartMate^®II continuous-flow left ventricular assist system

Mechanical Circulatory Support

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Use of a Prosthetic Ventricle as a Bridge to Cardiac Transplantation for Postinfarction Cardiogenic Shock

Cited by 132 publications

References 7 publications

Endoscopic Findings and Clinical Outcomes in Ventricular Assist Device Recipients with Gastrointestinal Bleeding

Endoscopic Findings and Clinical Outcomes in Ventricular Assist Device Recipients with Gastrointestinal Bleeding

HeartMate®II continuous-flow left ventricular assist system

Mechanical Circulatory Support

Contact Info

Product

Resources

About

HeartMate^®II continuous-flow left ventricular assist system