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Ventricular Support (ventricular + support)
Selected AbstractsNew Devices for Chronic Ventricular SupportJOURNAL OF CARDIAC SURGERY, Issue 3 2001F.A.C.S., F.C.C.P., Kenneth L. Franco M.D. Congestive heart failure affects 5 million people in the United States with 500,000 new cases diagnosed each year. Medical and surgical therapy have helped many patients but when these options fail, heart transplantation remains the only other treatment available to help improve their condition. Heart transplantation suffers from the lack of a sufficient number of suitable donor organs, the complications of chronic immunosuppression, and many patients die while on the waiting list. A number of pulsatile and nonpulsatile cardiac assist devices are being developed to provide chronic support for patients with heart failure and to be an alternative to heart transplantation. It is estimated that as many as 60,000 patients with heart failure could be helped by mechanical devices used for chronic support. For these devices to be effective they must provide sufficient cardiac output to allow patients to perform their daily activities, have a low risk of thromboemboli, be fully implantable thereby reducing the risk of infection, and have a low incidence of device malfunction requiring part or all of the device to be replaced. In this article, we will review several new devices which have been developed over the past 5 years or so and will be in human clinical trials in the United States soon, either as a bridge or as an alternative to heart transplantation. [source] Bridging Patients to Cardiac TransplantationCONGESTIVE HEART FAILURE, Issue 5 2000Michael B. Higginbotham MD Potential recipients of heart transplants have the most advanced form of congestive heart failure, in which standard therapy fails to maintain clinical stability. In the absence of guidelines derived from evidence obtained in clinical trials, caring for these patients becomes a challenge. A successful approach requires the proper coordination of surgical and nonsurgical strategies, including revascularization and valvular surgery as well as mechanical ventricular support and medical strategies. Intensive medical therapy is the most commonly used approach for prolonged bridging to transplantation. Although carefully individualized regimens are necessary to achieve desired goals, most centers adopt a fairly standardized approach involving vasodilators, diuretics, and inotropic support. Bridging patients with cardiac decompensation to transplantation presents a major therapeutic challenge. Appropriate strategies will maximize patients' chances that the bridge from decompensation to transplantation remains intact. [source] Myocardial Failure Caused by Traumatic Dissection of Left Coronary System,Ventricular Recovery with Temporary Circulatory SupportJOURNAL OF CARDIAC SURGERY, Issue 3 2007Alexander Lauten M.D. The dissection involved the left coronary artery including peripheral segments of the coronary circulation. The patient was revascularized; however, she could not be weaned from cardiopulmonary bypass thereafter. An Impella microaxial hemopump was implanted and the patient's left ventricular function markedly improved during the following days. Eight days later hemodynamics had stabilized far enough to explant the device, after explantation the patient remained hemodynamically stable and free of inotropic support. The report intends to emphasize the potential of the myocardium to recover even after extensive infarction under temporary ventricular support and takes the Impella microaxial hemopump into consideration as a device that is technically easy to implant with no injury to the ventricle and thus associated with good properties for weaning. Surgeons should consider the device as short-term support in borderline indications. [source] Initial Experience with a New Right Ventricular Support Device for Beating Heart SurgeryARTIFICIAL ORGANS, Issue 1 2004Ferdinand Kuhn-Régnier Abstract:, Objective: Device supported beating heart surgery has been advocated to extend patient selection criteria for off-pump surgery. This article reports the initial experimental and clinical results with a novel paracardial right ventricular support device. Methods: Preclinical experiments were performed in two pigs. Ten elective patients with triple vessel disease were subjected to beating heart coronary artery bypass grafting surgery during right ventricular support by the paracardial device. Measurements included intraoperative hemodynamics during cardiac tilting, perioperative left ventricular ejection fraction (LVEF), hemolysis parameters, mortality and major morbidity events. Results: A mean of 3.2 ± 0.2 distal anastomoses per patient were performed. Mean arterial pressure and central venous oxygen saturation remained stable during cardiac tilting. Perioperative LVEF did not vary significantly. Sixty-day mortality and postoperative infarction rate were 0%. Functional Canadian Cardiovascular Society class at 6 days after surgery was 1.2 ± 0.1 vs. 3.3 ± 0.2 pre-operatively. Conclusion: In this initial clinical experience, application of the novel paracardial right ventricular support device proved ,to be safe and efficient. [source] | ||||||||||