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Current status of heart assist and replacement in Taiwan

S S Wang1, S H Chu

  • 1Department of Surgery, National Taiwan University, Taipei.

Artificial Organs
|December 1, 1996
PubMed

Insights

Intraaortic balloon pumps (IABP) are common circulatory assist devices in Taiwan, while extracorporeal membrane oxygenation (ECMO) serves as a good emergency rescue option. Heart transplantation shows promising survival rates, emphasizing the need for organ donation.

Area of Science:

  • Cardiovascular Surgery
  • Transplantation Medicine
  • Critical Care Medicine

Background:

  • Intraaortic balloon pumps (IABP) have been clinically used in Taiwan since 1976 for post-cardiotomy cardiogenic shock, becoming a prevalent circulatory assist.
  • Extracorporeal membrane oxygenation (ECMO) was introduced in 1987 for intractable heart failure post-transplant, but its use has been limited due to poor outcomes.
  • Ventricular assist devices (VADs) are considered for long-term support, with a case highlighting the need for timely implantation before organ failure.

Purpose of the Study:

  • To review the clinical applications and outcomes of IABP, ECMO, and heart transplantation in Taiwan.
  • To assess the effectiveness and survival rates associated with different circulatory assist devices and heart transplantation.
  • To identify factors influencing the success of these advanced cardiac interventions.

Main Methods:

  • Retrospective analysis of patient data for IABP, ECMO, and heart transplantation from 1991-1995.
  • Evaluation of mortality and survival rates for patients receiving IABP support.
  • Assessment of ECMO support outcomes, including weaning and discharge rates.
  • Review of heart transplantation data, including operative mortality and actuarial survival rates.

Main Results:

  • From 1991-1995, 186 patients received IABP support with a 41.9% overall mortality rate; male patients undergoing coronary artery bypass grafting had a 67% survival rate.
  • Between November 1994 and November 1995, 30 patients received ECMO, with 50% weaned and 27% discharged, indicating its utility for short-term or emergency support.
  • Between 1991-1995, 102 patients underwent heart transplantation with a 3.9% operative mortality and 1- and 5-year actuarial survival rates of 86% and 77%, respectively.

Conclusions:

  • IABP remains a common circulatory assist, while ECMO is valuable for short-term or emergency rescue.
  • Heart transplantation in Taiwan has demonstrated favorable survival rates, suggesting the potential for improved outcomes.
  • Encouraging organ donation is crucial to enhance the success rates of clinical heart transplantation and improve patient survival.

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