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Bridging from acute to chronic devices.

W P Dembitsky¹

¹Sharp Memorial Hospital, San Diego, California, USA. cvsurgery@aol.com

The Annals of Thoracic Surgery

|September 4, 1999

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Mechanical circulatory support bridges patients to transplantation. A new group needs acute-to-chronic support, requiring careful management for successful long-term outcomes.

Area of Science:

Cardiology and Mechanical Circulatory Support

Background:

Mechanical circulatory support (MCS) is established for bridging patients to heart transplantation.
A growing patient population requires transitioning from temporary "acute" MCS to long-term "chronic" devices.

Purpose of the Study:

To summarize the current use of acute and chronic MCS devices.
To outline management principles for the emerging acute-to-chronic bridge patient group.

Main Methods:

Review of current utilization of acute and chronic mechanical circulatory support devices.
Analysis of the emerging patient population requiring acute-to-chronic bridging.
Synthesis of current management strategies for this specific patient cohort.

Main Results:

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Mechanical circulatory support is a standard bridge to transplantation.

A distinct group of patients requires acute-to-chronic MCS bridging for transplantation or permanent device implantation.

Optimal management strategies for acute-to-chronic bridge patients are still evolving.

Conclusions:

Careful management of the acute-to-chronic bridge patient group is crucial for long-term success.
Further analysis of larger patient populations will refine best practices for this emerging group.