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Trends and outcomes of heart transplantation in adults with congenital heart disease. Eur J Cardiothorac Surg 2024; 65:ezae086. [PMID: 38447194 DOI: 10.1093/ejcts/ezae086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 02/09/2024] [Accepted: 03/05/2024] [Indexed: 03/08/2024] Open
Abstract
OBJECTIVES Heart transplantation for adult congenital heart disease is complicated and associated with challenging pretransplant support, long waiting and high early post-transplant mortality. We explored if surgical and medical advances and allocation system changes have affected outcomes. METHODS From United Network for Organ Sharing database, adults with congenital heart disease listed for heart transplantation were queried. To explore practice and outcome trends, patients were divided into 4 eras (eras 1-3: nearly 3 equal periods from 1992 to 2018, era 4: after 2018, corresponding with new allocation system). Univariate and multivariable analysis was performed to evaluate outcomes. RESULTS A total of 2737 patients were listed. There was gradual increase in listed and transplanted patients, along with significant increase in use of mechanical support, simultaneous kidney and liver transplantation. While proportion of transplanted remained constant, there was decrease in proportion delisted/died after listing (P = 0.01) and waiting list duration (P = 0.01), especially in era 4. Thirty-day post-transplant mortality remains high; however, it has significantly improved starting era 3 (P = 0.01). Current survival at 1-year and 5-years is 85% and 65%, with improvement mainly related to decreased early death. On multivariable analysis, factors associated with survival were lower glomerular filtration rate (hazard ratio = 0.99, P = 0.042), bilirubin (hazard ratio = 1.17, P<0.001) and mechanical ventilation (hazard ratio = 2.3, P=0.004). CONCLUSIONS Heart transplantation in adults with congenital heart disease is increasing, along with added complexity, higher usage of pretransplant mechanical support and simultaneous organ transplantation. Despite that, more complex patients do not experience worse outcomes. Early mortality improved but remains high. New donor allocation system allowed shorter waiting time and higher proportion transplanted without altering early mortality.
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Initial Safety Cohort Analysis: Prospective Multi-Center Randomized Study for Evaluating The EVAHEART®2 Left Ventricular Assist System (The COMPETENCE Trial). J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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3
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Multicenter Development and Validation of a Machine Learning Model to Predict Myocardial Recovery During LVAD Support: The UCAR Score. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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4
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Predictors of Survival after Heart Transplantation in the Current Era. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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5
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“Extension” of Status in the New Heart Transplant Allocation System. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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The COMPETENCE Trial: Prospective Multi-Center Randomized Study for Evaluating the EVAHEART®2 Left Ventricular Assist System. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Impact of the 2016 Organ Procurement and Transplantation Network (OPTN) Pediatric Heart Allocation Policy Change on Use of Durable Ventricular Assist Devices and Heart Transplantation Rates in Children with Congenital Heart Disease versus Cardiomyopathy. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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B-AB23-03 TACHYCARDIA ZONE PROGRAMMING AND ARRHYTHMIC OUTCOMES IN CONTINUOUS FLOW LVAD RECIPIENTS. Heart Rhythm 2021. [DOI: 10.1016/j.hrthm.2021.06.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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OUTCOMES OF VAD VS. NO-VAD IN ADULTS WITH CONGENITAL HEART DISEASE AS A BRIDGE TO TRANSPLANT IN RECENT ERA: ANALYSIS FROM UNITED NETWORK FOR ORGAN SHARING DATABASE. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)01929-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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10
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Predictors of Myocardial Recovery Following LVAD-Mediated Reverse Remodeling and Device Removal: Insights from RESTAGE-HF. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Outcomes of ECMO versus VAD in Children with Congenital Heart Disease as a Bridge to Transplant in Recent Era: Analysis from United Network for Organ Sharing Database. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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12
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Early Bleeding is Associated with Increased Length of Stay and Early Death in LVAD Recipients. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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13
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Predicting Cardiac Structural and Functional Improvement Induced by Mechanical Unloading in Chronic Heart Failure: A Derivation-Validation Multicenter Study. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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14
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American Association for Thoracic Surgery/International Society for Heart and Lung Transplantation guidelines on selected topics in mechanical circulatory support. J Thorac Cardiovasc Surg 2020; 159:865-896. [DOI: 10.1016/j.jtcvs.2019.12.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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15
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American Association for Thoracic Surgery/International Society for Heart and Lung Transplantation guidelines on selected topics in mechanical circulatory support. J Heart Lung Transplant 2020; 39:187-219. [PMID: 31983666 DOI: 10.1016/j.healun.2020.01.1329] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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16
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Early Results from the FDA Extracellular Matrix (ECM) Cylinder Valve Clinical Feasibility Trial. STRUCTURAL HEART 2020. [DOI: 10.1080/24748706.2020.1717212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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17
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The opioid epidemic and intravenous drug-associated endocarditis: A path forward. J Thorac Cardiovasc Surg 2019; 159:1273-1278. [PMID: 31627948 DOI: 10.1016/j.jtcvs.2019.08.112] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 08/04/2019] [Accepted: 08/06/2019] [Indexed: 01/24/2023]
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18
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Relationship between Length of Hospital Stay Post LVAD Implant and Survival: The Potential for Understanding a Less Sick Population. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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19
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Impact of Center Volume on Post Heart Transplant Survival. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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20
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Cost-Effectiveness of Mitral Valve Repair Versus Replacement for Severe Ischemic Mitral Regurgitation. Circ Cardiovasc Qual Outcomes 2018. [DOI: 10.1161/circoutcomes.117.004466] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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21
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Pulmonary Dynamic Compliance for Prediction of Mortality in Adult Severe Acute Respiratory Distress Syndrome Treated With Veno-Venous Extracorporeal Membrane Oxygenation. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Abstract
Left ventricular assist device (LVAD) treatment may lead to reverse remodeling in heart failure patients. Selected patients can recover heart function and be eligible for LVAD explantation. Surgical methods for explanting an LVAD have been reported using various surgical accesses and different degrees of retained device material. We report a surgical technique for achieving a complete pump removal, with an emphasis on the technical details of inflow and outflow pump cannula management.
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23
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The Use of Eptifibatide Alone or in Combination With Heparin or Argatroban for Suspected Thrombosis in Patients With Left Ventricular Assist Devices. Artif Organs 2017. [DOI: 10.1111/aor.12910] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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24
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Performance of a Novel Shuttling Total Artificial Heart on a on a Mock Circulatory Loop. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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RA Pressure and RV Enlargement Are Predictive of Heart Failure Hospitalizations in Patients with LVAD. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Transplantation in Adults with Congenital Heart Disease: A Special Exception. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Global Experience with the Heartware HVAD® in Pediatric Patients: A Preliminary Analysis. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.121] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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The Use of Integrilin Alone or in Combination with Heparin or Argatroban for Suspected Pump Thrombosis in Patients with Left Ventricular Assist Devices. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Fibrin Density and Platelet Location Varies Based on HeartMate II Thrombus Site. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Risk Assessment for HeartWare HVAD Support as a Bridge to Transplant: Is the HeartMate II Risk Score Applicable? J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Remission From Stage D Heart Failure (RESTAGE-HF): Early Results From a Prospective Multi-Center Study of Myocardial Recovery. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.096] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Welcome to ISRBP 2014. Artif Organs 2014; 38:725-6. [PMID: 25234755 DOI: 10.1111/aor.12405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Diagnostic Utility of Capsule Endoscopy in Evaluating GI Bleeding in LVAD Patients. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Reply to the editor. J Thorac Cardiovasc Surg 2013; 146:243-4. [PMID: 23768808 DOI: 10.1016/j.jtcvs.2013.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 03/06/2013] [Indexed: 10/26/2022]
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35
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Racial Differences in over 1000 Patients with Continuous Flow Left Ventricular Assist Devices. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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RACIAL DIFFERENCES IN OVER 1,000 PATIENTS WITH CONTINUOUS FLOW LEFT VENTRICULAR ASSIST DEVICES. J Am Coll Cardiol 2013. [DOI: 10.1016/s0735-1097(13)60721-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Clinical, molecular, and genomic changes in response to a left ventricular assist device. J Am Coll Cardiol 2011; 57:641-52. [PMID: 21292124 DOI: 10.1016/j.jacc.2010.11.010] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Revised: 10/25/2010] [Accepted: 11/08/2010] [Indexed: 12/20/2022]
Abstract
The use of left ventricular assist devices in treating patients with end-stage heart failure has increased significantly in recent years, both as a bridge to transplantation and as destination therapy in those who are ineligible for cardiac transplantation. This increase is based largely on the results of several recently completed clinical trials with the new second-generation continuous-flow devices that showed significant improvements in survival, functional capacity, and quality of life. Additional information on the use of the first- and second-generation left ventricular assist devices has come from a recently released report spanning the years 2006 to 2009, from the Interagency Registry for Mechanically Assisted Circulatory Support, a National Heart, Lung, and Blood Institute-sponsored collaboration between the U.S. Food and Drug Administration, the Centers for Medicare and Medicaid Services, and the scientific community. The authors review the latest clinical trials and data from the registry, with tight integration of the landmark molecular, cellular, and genomic research that accompanies the reverse remodeling of the human heart in response to a left ventricular assist device and functional recovery that has been reported in a subset of these patients.
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Pulmonary Mechanics and Gas Transfer After VAD Implantation: Pilot Study of Pulmonary Function Test Measures Before and After LVAD Implantation. Chest 2011. [DOI: 10.1378/chest.1119483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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39
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The total artificial heart. Panminerva Med 2011; 53:141-154. [PMID: 21775941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
In the 1960s, cardiac surgeons and biomedical engineers pioneered the development of total artificial hearts (TAH) for the treatment of left and right heart failure. As we mark the 10th anniversary of the first implantation of the AbioCor device, the use of TAH has been limited, having failed to reach its envisioned potential and promise as an alternative therapy to heart transplantation. The Syncardia/CardioWest device, originally developed 30 years ago as the Jarvik TAH and later renamed the CardioWest TAH, continues to be used clinically in over 50 centers within the US and Europe having supported over 900 patients worldwide. Syncardia continues to develop TAH technology as evidenced by their recent introduction of a new portable pneumatic driver that enables patients to be discharged from the hospital. In contrast to TAH devices, continuous flow ventricular assist devices (VAD) have made tremendous technological strides and are rapidly gaining widespread clinical acceptance. The VAD technology has demonstrated extraordinary safety and reliability records through evolving technologies, advanced biocompatible materials, and improved patient management. Subsequently, the number of TAH implantations remains low compared to the growth in LVAD implants. Nonetheless, the Syncardia/CardioWest TAH remains an important and viable option for patients with severe biventricular failure and end organ dysfunction. Overall, a 79% survival rate has been achieved in patients supported with a Syncardia/CardioWest TAH as bridge-to-transplantation. In this review article, a brief history on the evolution of TAH devices, their current use and emerging use of evolving continuous flow VAD technology as chronic biventricular and TAH device systems are presented.
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4 National Trends in Readmission(REA) Rates Following Left Ventricular Assist Device (LVAD) Therapy. J Heart Lung Transplant 2011. [DOI: 10.1016/j.healun.2011.01.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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APPLICATION OF THE SEATTLE HEART FAILURE MODEL TO THE HEARTWARE BRIDGE TO TRANSPLANT US TRIAL. J Am Coll Cardiol 2011. [DOI: 10.1016/s0735-1097(11)60321-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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42
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Is female gender an independent risk factor for peri-operative RBC transfusion in coronary artery bypass graft surgery? J Am Coll Surg 2010. [DOI: 10.1016/j.jamcollsurg.2010.06.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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143: Pump Replacement for LVAD Failure Can Be Done Safely and Is Associated with Low Mortality. J Heart Lung Transplant 2010. [DOI: 10.1016/j.healun.2009.11.152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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313: Outcomes of Medical Therapy and Mechanical Circulatory Support as Bridge to Transplantation in UNOS Status 1 Heart Transplant Candidates – Analysis of the U.S. UNOS/OPTN Data, Years 1999-2007. J Heart Lung Transplant 2009. [DOI: 10.1016/j.healun.2008.11.320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Abstract
BACKGROUND/AIMS To determine if disease severity is associated with a family history of keratoconus. METHODS Markers of disease severity in the CLEK Study cohort were assessed to determine if they could discriminate individuals with and without family history. Logistic regression was used to examine association between corneal scarring, average corneal power, flat and steep keratometry readings, and higher-order root mean square (RMS) wavefront error with family history. RESULTS In univariate analyses, none of the severity indices had any significant associations with family history; however, contact lens use, gender, and Caucasian race were found to be significant predictors. After controlling for these confounders, there were no significant associations between any severity indices and family history. CONCLUSIONS Presence or absence of family history is not associated with more severe clinical disease, at least when each marker for severity is considered independently. The results of this analysis are important for genetic studies of keratoconus in that it will allow recruitment of keratoconus patients across all stages of disease severity because it does not influence familial aggregation.
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Can We Detect Fatal Heart Failure? J Card Fail 2008. [DOI: 10.1016/j.cardfail.2008.06.406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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333: Center experience and outcomes of left-ventricular assist device (LVAD) implantation as destination therapy (DT) – analysis of thoratec DT registry 1998-2005. J Heart Lung Transplant 2007. [DOI: 10.1016/j.healun.2006.11.353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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IMPACT OF LEFT VENTRICULAR ASSIST DEVICE DESTINATION THERAPY ON VENTRICULAR RE-SYNCHRONIZATION. Chest 2005. [DOI: 10.1378/chest.128.4_meetingabstracts.281s-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Abstract
The syndrome of heart failure is epidemic, causing increased hospital admissions, poor survival rates, and a dismal quality of life. Treatment choices include pharmacologic, psychological, and surgical interventions. Recent data suggest that mechanical heart pumps, or assist devices, are viable additions or alternatives to transplantation in management of advanced heart failure. A ventricular assist device (VAD) can support the circulation when the natural heart is unable to maintain adequate perfusion. Although its use continues to be explored, VADs can be used in three ways: as a bridge to transplantation, as a destination therapy (or implanted permanently), or as a bridge to recovery. As VAD science advances, nurses will needs to understand its practice implications.
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