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Mechanical circulatory support and heart transplantation
R Hetzer1, E Hennig, A Schiessler
1Deutsches Herzzentrum Berlin, Germany.
Summary
Mechanical circulatory support systems can sustain patients with cardiogenic shock, aiding cardiac recovery or bridging to heart transplantation. While some patients achieve recovery, reliable outcome prediction for transplant candidates requires further study.
Area of Science:
- Cardiology
- Medical Engineering
Background:
- Mechanical circulatory support (MCS) systems are vital for patients with severe heart conditions.
- These systems offer life support for cardiac recovery or as a bridge to heart transplantation.
Purpose of the Study:
- To evaluate the outcomes of the "Berlin Heart" MCS system at the German Heart Institute.
- To analyze patient survival and identify risk factors in different clinical scenarios.
Main Methods:
- Retrospective analysis of patients treated with the "Berlin Heart" MCS system between 1987 and 1991.
- Categorization of patients into "recovery" and "bridge to transplantation" groups.
Main Results:
- In the "recovery" group (22 patients), only 1 out of 4 weaned patients was discharged.
- In the "bridge to transplantation" group (65 patients), 22 out of 39 transplanted patients were discharged.
- Factors like prior heart surgery, pneumonia, coagulation disorders, and age >50 negatively impacted survival in the bridging group.
Conclusions:
- MCS systems can prolong survival in cardiogenic shock and facilitate recovery from acute graft failure post-transplant.
- Further research is needed to accurately predict outcomes for patients on MCS as a bridge to transplantation.