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Related Experiment Videos

Mechanical cardiac assistance

Y Sezai1

  • 1Second Department of Surgery, Nihon University School of Medicine, 30-1 Oyaguchi, Kami-machi, Itabashi-ku, Tokyo 173-8610, Japan.

Annals of Thoracic and Cardiovascular Surgery : Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
|September 17, 1998
PubMed
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Mechanical cardiac assist devices, including pneumatic ventricular assist devices (VAD) and percutaneous cardiopulmonary support (PCPS), offer options for severe heart failure. Device selection depends on support duration and patient status for optimal outcomes.

Area of Science:

  • Cardiology
  • Mechanical Circulatory Support
  • Heart Failure Management

Background:

  • Severe heart failure necessitates mechanical cardiac assistance.
  • Pulsatile and non-pulsatile devices, including VADs and PCPS, are utilized.
  • Centrifugal pumps are commonly used in these systems.

Purpose of the Study:

  • To retrospectively evaluate clinical outcomes of mechanical cardiac assist devices.
  • To propose an alternative strategy for mechanical cardiac assistance in severe heart failure.
  • To guide device selection based on clinical scenarios and support duration.

Main Methods:

  • Retrospective analysis of clinical cases involving VAD and PCPS.
  • Evaluation based on weaning results, long-term survival, and causes of death.

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  • Assessment of end-organ function and expected support duration for device selection.

    • Main Results:

    • PCPS, with intra-aortic balloon pumping (IABP) assist, is recommended for initial 2-3 day support in post-cardiotomy cardiogenic shock or low output syndrome.
    • VADs are suggested for longer-term support if native cardiac function doesn't recover.
    • Device selection is crucial, considering support duration: centrifugal pumps for short-term, pulsatile devices for broader spectrum, pneumatic VADs up to a year, and electric VADs for over a year (bridge to transplantation).

    Conclusions:

    • An alternate strategy for mechanical cardiac assistance is proposed based on clinical experience.
    • Appropriate device selection is critical for optimizing clinical results in severe heart failure.
    • Pneumatic and electric VADs offer varying durations of support, with electric VADs serving as a bridge to heart transplantation.