Related Experiment Videos
[Selection of candidates for a ventricular assist device as a bridge to heart transplantation]
Insights
This study identified key criteria for selecting patients for a ventricular assist device (VAD) as a bridge to heart transplantation. Careful hemodynamic and organ function evaluation is crucial for successful VAD candidacy.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Transplantation Medicine
Context:
- The study retrospectively analyzed 9916 patients admitted between 1984 and 1987.
- 399 deceased patients were evaluated for potential Ventricular Assist Device (VAD) candidacy.
- Identified 42 potential VAD candidates, with 10 (23.8%) meeting criteria for VAD bridge to transplantation.
Purpose:
- To determine the number of patients eligible for VAD as a bridge to heart transplantation.
- To establish recipient selection criteria for VAD implantation.
- To analyze factors influencing VAD candidacy in critically ill cardiac patients.
Summary:
- Analyzed 42 potential VAD candidates (31 male, 11 female, average age 50).
- Established three primary indications for VAD bridge to transplantation: cardiogenic shock, end-stage valvular heart disease, and postoperative refractory ventricular failure.
- Highlighted the importance of continuous hemodynamic monitoring and intensive care for major organ functions in candidate selection.
Impact:
- Provides critical insights into VAD selection criteria for heart transplantation.
- Emphasizes the necessity of precise hemodynamic assessment and comprehensive organ support.
- Contributes to optimizing patient selection for VAD therapy, potentially improving transplant outcomes.
Abstract:
This study was undertaken to see how many people could receive the ventricular assist device (VAD) as a bridge to heart transplantation and to get selection criteria of the recipient. From January 1984 to December 1987, 9916 patients were admitted to our institute and 399 cases of them were dead. All dead cases were examined in terms of age, heart disease, other organ function, infection, and so on. There were 42 possible candidates for VAD, 31 men and 11 women. The average age was 50 years with a range from 22 to 63 years. Ten cases (23.8%) of them had the indication for VAD bridge to transplantation. The criteria for transplantable patients included the following three categories: I) Cardiogenic shock: Irreversible left or double ventricular failure with or without life-threatening dysrhythmia during IABP therapy--4 cases. II) End-stage valvular heart disease; Operation under VAD stand-by--2 cases. III) Postoperative refractory ventricular pump failure: Failure to wean from assist circulation after IABP trial or sustained ventricular failure under IABP support--4 cases. It was indicated that continuous precise evaluation of the deteriorating hemodynamics and the intensive care for major organ functions (renal, pulmonary, neurologic, hepatic, coagulation, etc.) were important to select the candidate for VAD bridge to heart transplantation.