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Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
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Implantation of the Syncardia Total Artificial Heart
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Transition From Temporary to Durable Circulatory Support Systems.

Diyar Saeed1, Evgenij Potapov2, Antonio Loforte3

  • 1Department of Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany; Department for Cardiac Surgery, Duesseldorf University Hospital, Duesseldorf, Germany.

Journal of the American College of Cardiology
|December 18, 2020
PubMed
Summary
This summary is machine-generated.

Implanting durable mechanical circulatory support (MCS) after extracorporeal life support (ECLS) is challenging. Preoperative factors can help identify patients who may benefit from MCS, improving selection and outcomes.

Keywords:
extracorporeal life supportextracorporeal membrane oxygenationmechanical circulatory supportoutcomepredictors

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Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Critical Care Medicine

Background:

  • Mechanical circulatory support (MCS) implantation after extracorporeal life support (ECLS) presents significant challenges due to anticipated poor patient outcomes.
  • Selecting appropriate candidates for durable MCS following ECLS requires careful consideration of patient-specific factors.

Purpose of the Study:

  • To identify predictors of outcomes in patients undergoing durable MCS implantation after ECLS.
  • To aid future patient selection and decision-making processes for this complex patient group.

Main Methods:

  • A multicenter retrospective study involving 531 patients who received durable MCS after ECLS between 2010 and 2018 across 11 European centers.
  • Data collection included perioperative parameters, with the primary endpoint being 1-year survival post-MCS implantation.

Main Results:

  • Overall 1-year survival rate was 53%.
  • Key predictors for 1-year survival included age, female sex, lactate levels, Model of End-Stage Liver Disease XI score, atrial fibrillation history, redo surgery, and obesity (BMI >30 kg/m²).
  • A risk score and an app were developed to estimate 1-year mortality.

Conclusions:

  • Outcomes for patients receiving durable MCS after ECLS remain limited.
  • Preoperative factors are crucial for distinguishing patients who may experience significant survival benefit from those with futile outcomes.