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Postcardiotomy mechanical circulatory support in the elderly
1Division of Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, Missouri.
The Annals of Thoracic Surgery
|March 1, 1991
Summary
Mechanical ventricular assist devices offer a viable option for elderly patients after heart surgery. This study shows comparable survival rates to younger patients, justifying their use in this demographic.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Biomedical Engineering
Background:
- The efficacy of mechanical circulatory support in elderly patients post-cardiac surgery remains uncertain.
- Elderly patients represent a growing demographic undergoing cardiac procedures.
Purpose of the Study:
- To evaluate the outcomes of mechanical ventricular assist device (MVAD) use in patients aged 65 and older following cardiotomy.
- To compare the results in elderly patients to existing data for younger populations.
Main Methods:
- Retrospective analysis of 18 patients (≥65 years) who received MVAD support (centrifugal vortex or pneumatic) after cardiac surgery between 1985 and 1989.
- Patients received maximal inotropic support and/or intra-aortic balloon pumps prior to MVAD initiation.
- Support was either univentricular (n=9) or biventricular (n=9), with a mean duration of 45 hours.
Main Results:
- 67% of patients were successfully weaned from MVAD support.
- 44% were discharged from the hospital, with 33% surviving at 11-31 months post-operation.
- Survival and functional outcomes in this elderly cohort were comparable to reported data for younger patients.
Conclusions:
- Mechanical ventricular assist device support is a justifiable option for elderly patients experiencing complications after cardiac surgery.
- Outcomes suggest that age alone should not be a contraindication for postcardiotomy MVAD therapy.