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Mechanical circulatory support: the Bad Oeynhausen experience
R Körfer1, A el-Banayosy, H Posival
1Department of Thoracic and Cardiovascular Surgery, Heart Center North Rhine-Westphalia, Ruhr University of Bochum, Bad Oeynhausen, Germany.
The Annals of Thoracic Surgery
|February 1, 1995
Summary
Mechanical circulatory support improved survival for 51% of patients. Patients bridged to cardiac transplantation (72% survival) fared best, while those with cardiogenic shock or other conditions faced lower survival rates and higher complication risks.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Medical Engineering
Background:
- Mechanical circulatory support (MCS) is critical for managing severe heart failure.
- Various MCS devices exist, each with potential benefits and risks.
- Understanding patient outcomes across different indications is vital for optimizing MCS use.
Purpose of the Study:
- To evaluate the effectiveness and complications of different mechanical circulatory support systems.
- To compare patient outcomes based on the indication for MCS implantation.
- To analyze survival rates and complication profiles for distinct patient groups.
Main Methods:
- Retrospective analysis of 147 patients (11-82 years old) treated between September 1987 and February 1994.
- Patients received various MCS devices: Bio-Medicus (n=61), Abiomed BVS (n=49), Thoratec VAD (n=42), Novacor LVAD (n=7).
- Patients categorized into three groups: postcardiotomy cardiogenic shock (n=72), bridge to transplant (n=50), and miscellaneous (n=25).
Main Results:
- Overall survival to discharge was 51% (75/147 patients).
- Highest survival rate was in the bridge-to-transplant group (72%), followed by postcardiotomy shock (44%), and miscellaneous (28%).
- Common complications included bleeding (up to 44%), multiple-organ failure (up to 60%), neurologic disorders (up to 22%), and renal failure (15%).
Conclusions:
- Mechanical circulatory support can significantly improve survival in selected cardiac patients.
- Bridge-to-transplant remains the most successful indication for MCS, offering a higher chance of survival.
- Careful management of complications like bleeding and organ failure is crucial for improving outcomes with MCS.