The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
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J. Heart Lung Transplant. · Feb 2008
The Papworth experience with the Levitronix CentriMag ventricular assist device.
The Levitronix CentriMag ventricular assist device (VAD) is a centrifugal pump designed for short-term extracorporeal support in cardiogenic shock. The aim of this study is to report our clinical experience with the Levitronix CentriMag for uni- and biventricular support. ⋯ The Levitronix CentriMag system is a reliable and facile temporary circulatory support system as a bridge to decision in patients with refractory acute cardiogenic shock.
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J. Heart Lung Transplant. · Feb 2008
Pneumatic paracorporeal ventricular assist device in infants and children: initial Stanford experience.
Mechanical circulatory support with the Berlin Heart EXCOR pediatric ventricular assist device (VAD) has been used successfully in Europe for children with cardiac failure. Eighty-seven devices have been placed in North America through February 2007. We describe our single-center experience in 8 children. ⋯ In selected children, the Berlin Heart VAD can be used as a bridge to transplantation. In contrast to the published European experience, neurologic events occur frequently. Anti-coagulation and platelet inhibition strategies continue to evolve. Device exchange is technically feasible at the bedside and should be considered at the earliest visualization of thrombus formation.
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J. Heart Lung Transplant. · Feb 2008
Comparative StudyOutcomes in patients older than 60 years of age undergoing orthotopic heart transplantation: an analysis of the UNOS database.
Patients 60 years and older have traditionally not been considered candidates for orthotopic heart transplantation (OHT). Recent studies have shown equivalent survival between older and younger patients, leading many to question this traditional ethos. As these studies may lack significant power to draw meaningful conclusions, the United Network for Organ Sharing (UNOS) database provides a unique opportunity to examine the effects of age on OHT. ⋯ The UNOS database has provided a large multi-institutional sample examining OHT in the elderly. Although our analysis shows lower survival in patients >or=60 years of age, the cumulative 5-year survival in these patients of close to 70% is acceptable. OHT should not be restricted based on age, as encouraging long-term results exist.
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J. Heart Lung Transplant. · Jan 2008
Comparative StudyUse of the percutaneous left ventricular assist device in patients with severe refractory cardiogenic shock as a bridge to long-term left ventricular assist device implantation.
For patients with persistent cardiogenic shock refractory to intraaortic balloon pump (IABP) support, there are only limited means of resuscitation and bridging to surgical left ventricular assist device (LVAD) implantation. Extracorporeal membrane oxygenation and emergency surgical approaches have been attempted but are associated with significant morbidity and mortality. We evaluated the efficacy of a percutaneous left ventricular assist device (PVAD) as a bridge to LVAD implantation in patients in cardiogenic shock refractory to IABP and pressor support. ⋯ In patients with terminal hemodynamic collapse, PVAD support is an effective bridging therapy to LVAD and appears to be a viable alternative to other invasive methods of support.
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J. Heart Lung Transplant. · Jan 2008
Case ReportsConnecting the Centrimag Levitronix pump to Berlin Heart Excor cannulae; a new approach to bridge to bridge.
An increasing number of children are requiring circulatory support. Hospitals offering pediatric Ventricular Assist Device (VAD) should have devices of different sizes available to cover the full range of patient sizes incurring considerable expense. As in adults, post-operative bleeding often complicates VAD implantation. The use of a Levitronix Centrimag centrifugal pump, connected to Berlin Heart Excor cannulae, seems an attractive and logic combination, both in terms of patient safety and of hospital economics. ⋯ The Levitronix Centrimag pump was easy to handle and gave effective circulatory support, the patients were only switched to the Berlin Heart Excor system after stabilization. In patients with a high risk of failure, it is a relatively cheap but safe and effective support system.