Use of Left-Ventricular Assist with the Hemopump&lt;sup&gt;TM&lt;/sup&gt; in Cardiac Surgery

Waldenberger, Ferdinand; Wouter, P.; Wiebalck, A.; Flameng, Willem

doi:10.1159/000176400

Cited by 12 publications

(8 citation statements)

References 7 publications

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“…Dedicated studies on the use of preoperative MCS for post‐MI VSD are limited to few case reports and small case series . Described indications for use of MCS include BTT, BTR, or BTD based on anticipated recovery of myocardial function and eligibility for transplant.…”

Section: Discussionmentioning

confidence: 99%

“…Dedicated studies on the use of preoperative MCS for post-MI VSD are limited to few case reports and small case series. [10][11][12][13][14][15][16][17][18][19][20][21] Described indications for use of MCS include BTT, BTR, or BTD based on anticipated recovery of myocardial function and eligibility for transplant. The MCS options are categorized as to centrally or peripherally cannulated devices.…”

Section: Review Of Literature For Mechanical Circulatory Support Aftementioning

confidence: 99%

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Mechanical Circulatory Support as a Bridge to Definitive Surgical Repair After Post-Myocardial Infarct Ventricular Septal Defect

et al. 2015

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Ventricular septal defect (VSD) after myocardial infarction (MI) is an uncommon but serious complication. Patients refractory to attempts at medical stabilization and requiring emergency surgery have expected mortality rates greater than 50%. We present three cases of extracorporeal membrane oxygenation bridge to surgical repair in patients with multisystem organ failure who would otherwise require emergent cardiac surgery with associated risk and review the literature for mechanical circulatory support for patients with anterior and posterior post-MI VSD.

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Section: Discussionmentioning

confidence: 99%

Section: Review Of Literature For Mechanical Circulatory Support Aftementioning

confidence: 99%

Mechanical Circulatory Support as a Bridge to Definitive Surgical Repair After Post-Myocardial Infarct Ventricular Septal Defect

et al. 2015

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“…Aufgrund der infolge der Dicke des Ansaugsystems (21 F ~ 7 mm) bestehenden Implantationsprobleme (trotz chirurgischer Implantation gelingt eine transfemorale Plazierung lediglich bei zwei Drittel der Patienten) und Komplikationsm/Sglichkeiten ist gegenw~irtig jedoch -zumindest fª den Einsatz in der Kardiologie -kein klarer Indikationsbereich fª dieses System abzugrenzen. In der Thoraxchirurgie k6nn-ten minimalinvasive Eingriffe ohne Herz-LungenMaschine, das Entw6hnen vom kardiopulmonalen Bypass, postoperatives ,,low output" sowie ,,low output" in der Akutphase einer TransplantatabstoBung m6gliche Indikationen zum Einsatz der Hemopumpe darstellen, zumal fª diesen Bereich inzwischen ein noch dickeres (26 F, transthorakale Plazierung) -und damit auch effektiveres -Hemopump-System zur Verfª steht [9,86,87]. Seit d e m erfolgreich v o r g e n o m m e n e n klinischen E r s t e i n s a t z der p e r k u t a n e n H e m o p u m p e ira J a h r e 1993 [66] w u r d e das System bisher an vier europfiischen Z e n t r e n bei insgesamt 32 P a t i e n t e n ausschlieglich ira R a h m e n einer s o g e n a n n t e n H o c h r i s i k o -P T C A eingesetzt, die B e h a n d l u n g s e r g e b n i s s e w u r d e n in e i n e m R e g i s t e r erfal3t [72].…”

Section: B) Transfemoral Implantierbarer Intrakorporaler Linksherzbypunclassified

Reperfusionstherapie und mechanische Kreislauf-unterstützung bei Patienten mit kardiogenem Schock

Scholz

1999

Herz

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Cardiogenic shock is a state of inadequate tissue perfusion due to cardiac dysfunction, which is most commonly caused by acute myocardial infarction. The pathophysiology of cardiogenic shock is characterized by a downward spiral: ischemia causes myocardial dysfunction, which, in turn, augments the ischemic damage and the energetical imbalance. With conservative therapy, mortality rates for patients with cardiogenic shock are frustratingly high reaching more than 80%. Additional thrombolytic therapy has not been shown to significantly improve survival in such patients. Emergency cardiac catheterization and coronary angioplasty, however, seem to improve the outcome in shock-patients, which most probably is due to rapid and complete revascularization generally reached by angioplasty. In addition to interventional therapy with rapid coronary revascularization, the use of mechanical circulatory support may interrupt the vicious cycle in cardiogenic shock by stabilizing hemodynamics and the metabolic situation. Different cardiac assist devices are available for cardiologists and cardiac surgeons: 1. intraaortic balloon counterpulsation (IABP), 2. implantable turbine-pump (Hemopump), 3. percutaneous cardiopulmonary bypass support (CPS), 4. right heart, left heart, or biventricular assist devices placed by thoracotomy, and 5. intra- and extrathoracic total artificial hearts. Since percutaneous application is possible with IABP, Hemopump and CPS, these devices are currently used in interventional cardiology. The basic goals of the less invasive intraaortic balloon counterpulsation (IABP; Figure 1) are to stabilize circulatory collapse, to increase coronary perfusion and myocardial oxygen supply, and to decrease left ventricular workload and myocardial oxygen demand (Figure 2). Since the advent of percutaneous placement, IABP has been used by an increasing number of institutions (Figure 3). In addition to cardiogenic shock, the system may be of use in a variety of other indications in the catheterization laboratory and intensive care unit, including weaning from percutaneous cardiopulmonary bypass, in ischaemic left ventricular failure, in unstable angina, in high risk PTCA, and in prophylactic support in patients with myocardial infarction and successful revascularization. Animal experimental data showed that IABP may improve success of thrombolysis and recent clinical data suggest that survival is enhanced and transfer for revascularization is facilitated when patients with myocardial infarction and cardiogenic shock undergo thrombolysis and IABP rather than thrombolysis alone. A lot of studies had demonstrated before, that combined use of counterpulsation and revascularization therapy (i.e. coronary bypass surgery or angioplasty) may improve prognosis in patients with myocardial infarction complicated by cardiogenic shock (Table 1). In such patients, early treatment with IABP is most important: Multivariate analysis identified early IABP-support with a duration of shock to IABP-treatment of > or = 4 hours as an independ...

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“…Auch wenn mittlerweile größere Patientenserien mit der "Hemopump" behandelt wurden, kann der Nutzen noch nicht abschließend bewertet werden [3,42,64]. Speziell beim Vorliegen der koronaren Herzkrankheit und ihrer Komplikationen wirken sich die Verbesserung der Myokarddurchblutung bei gleichzeitiger Senkung des Sauerstoffverbrauchs günstig aus.…”

Section: Indikationenunclassified

Mechanische myokardiale Unterstützungssysteme 1997Eine Übersicht von der intraaortalen Ballongegenpulsation bis zu den implantierbaren linksventrikulären Unterstützungssystemen

et al. 1997

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The development of cardiopulmonary bypass (CPB) to support the systemic circulation during cardiac surgical procedures became a clinical reality in 1953. Although the use of CPB for the treatment of post-infarction cardiogenic shock met with little success, intra-aortic balloon counterpulsation was used successfully in 1968 to reduce ischaemic injury in a patient with cardiogenic shock. Today, a broad spectrum of circulatory assist devices for short- and long-term application is available. Three major indication groups for the use of support devices are established. In low-cardiac-output syndrome after cardiac surgical procedures, short-term devices are utilised to enable myocardial recovery. In transplantation candidates suffering from drug-resistant pump failure, the implantation of long-term devices as a bridge to heart transplantation is indicated, and in NYHA class IV patients with contraindications to heart transplantation, the implantation of long-term devices as an alternative to transplantation is under discussion. In the literature, post-cardiotomy support survival is less than 30% on average. About 70% of mechanically bridged patients have survived to undergo heart transplantation and were transplanted with over 90% survival. Major problems during mechanical support are infection, bleeding, and thromboembolism. In view of patients' natural course without support, these clinical results are favourable.

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Use of Left-Ventricular Assist with the Hemopump<sup>TM</sup> in Cardiac Surgery

Cited by 12 publications

References 7 publications

Mechanical Circulatory Support as a Bridge to Definitive Surgical Repair After Post-Myocardial Infarct Ventricular Septal Defect

Mechanical Circulatory Support as a Bridge to Definitive Surgical Repair After Post-Myocardial Infarct Ventricular Septal Defect

Reperfusionstherapie und mechanische Kreislauf-unterstützung bei Patienten mit kardiogenem Schock

Mechanische myokardiale Unterstützungssysteme 1997Eine Übersicht von der intraaortalen Ballongegenpulsation bis zu den implantierbaren linksventrikulären Unterstützungssystemen

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