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Rescue extracorporeal life support as a bridge to durable left ventricular assist device
- Source :
- International Journal of Artificial Organs, 45(4), 371-378. Wichtig Publishing
- Publication Year :
- 2022
-
Abstract
- Background: The ideal timing of a durable assist device implantation in patients with end-stage heart failure presenting with INTERMACS profile I is still controversial. The data on extracorporeal life support (ECLS) bridge to durable left ventricular assist device (LVAD) in these patients is limited. Materials and methods: We retrospectively analyzed the outcomes of 35 patients in acute cardiogenic shock (CS) who, between December 2013 and September 2020, were bridged with ECLS to durable LVAD. The mean age was 52.3 ± 12.0 years. The primary endpoints of this study were in-hospital, 30-day, 6-month, and 1-year mortality. The secondary endpoint was the development of any postoperative adverse events and other characteristics during the follow-up period. We also assessed the impact of the rescue ECLS on the recovery of the end-organ function. Results: In-hospital, 30-day, 6-month, and 1-year survival was 65.6%, 75.9%, 69.2%, and 62.7% respectively. The median time on ECLS was 7 days (IQR 5.0–13.0). We observed a high incidence of a severe right heart failure (22.9%), acute kidney injury on dialysis (68.6%), and respiratory failure (77.1%). Bridge with ECLS provided a significant recovery of liver and kidney function prior to durable LVAD implantation. Conclusion: The concept of bridging patients presenting in end-stage heart failure and cardiogenic shock with ECLS prior to durable LVAD implantation is a feasible method to ensure acceptable survival rates and significant recovery of the end-organ function.
- Subjects :
- Adult
medicine.medical_specialty
medicine.medical_treatment
Medizin
Shock, Cardiogenic
Biomedical Engineering
Medicine (miscellaneous)
Bioengineering
Extracorporeal
Biomaterials
Extracorporeal Membrane Oxygenation
Internal medicine
medicine
Humans
Dialysis
Retrospective Studies
Heart Failure
business.industry
Cardiogenic shock
Acute kidney injury
Shock
General Medicine
Middle Aged
medicine.disease
Cardiogenic
Treatment Outcome
Respiratory failure
Heart failure
Ventricular assist device
Life support
Cardiology
Heart-Assist Devices
business
Heart Failure/surgery
Subjects
Details
- Language :
- English
- ISSN :
- 03913988
- Volume :
- 45
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- International Journal of Artificial Organs
- Accession number :
- edsair.doi.dedup.....9eeefa2bbc546b989cf58904b1d98838