A Novel Extracorporeal Continuous-Flow Ventricular Assist System for Patients With Advanced Heart Failure - Initial Clinical Experience
| Autor: | Kensuke Kuroda, Haruko Yamamoto, Junjiro Kobayashi, Satsuki Fukushima, Nana Kitahata, Toshimitsu Hamasaki, Seiko Nakajima, Teruyuki Hayashi, Masanobu Yanase, Eisuke Tatsumi, Tomoyuki Fujita, Keiichiro Iwasaki, Yoshiaki Takewa, Kaori Onda, Osamu Seguchi, Norihide Fukushima, Tomonori Tsukiya, Takuya Watanabe, Nobumasa Katagiri, Toshihide Mizuno |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Myocarditis Time Factors medicine.medical_treatment 030204 cardiovascular system & hematology Prosthesis Design Extracorporeal Ventricular Function Left Prosthesis Implantation 03 medical and health sciences 0302 clinical medicine Extracorporeal Membrane Oxygenation Internal medicine medicine Extracorporeal membrane oxygenation Humans 030212 general & internal medicine Heart Failure business.industry Dilated cardiomyopathy General Medicine Recovery of Function Middle Aged medicine.disease Treatment Outcome Respiratory failure Ventricular assist device Heart failure Circulatory system Cardiology Ventricular Function Right Heart Transplantation Female Heart-Assist Devices Cardiology and Cardiovascular Medicine business |
| Zdroj: | Circulation journal : official journal of the Japanese Circulation Society. 84(7) |
| ISSN: | 1347-4820 |
| Popis: | Background Bridge-to-decision (BTD) devices providing temporary mechanical circulatory support should be introduced to patients with advanced heart failure. This study evaluated the effectiveness and safety of a BTD device comprising an innovative extracorporeal continuous-flow temporary ventricular assist device (VAD) driven by a novel hydrodynamically levitated centrifugal flow blood pump.Methods and Results:Nine patients, comprising 3 with dilated cardiomyopathy, 3 with fulminant myocarditis, and 3 with ischemic heart disease, and 6 males, whose mean age was 47.7±8.1 years, were enrolled into the study. Six patients had Interagency Registry for Mechanically Assisted Circulatory Support profile 1, and 3 were profile 2. The primary endpoint was a composite of survival free from device-related serious adverse events and complications during circulatory support. Eight patients received left ventricular support, of whom 3 received concomitant right ventricular support using extracorporeal membrane oxygenation circuits, as a consequence of severe respiratory failure. One patient with fulminant myocarditis received biventricular support using the novel VAD system. After 19.0±13.5 days, 3 patients were weaned from circulatory support, because their native cardiac function recovered, and 6 patients required conversion to a durable device as a bridge-to-transplantation. One patient had non-disabling ischemic stroke episodes, and no patients died. Conclusions This novel extracorporeal VAD system with a hydrodynamically levitated centrifugal pump can safely and successfully bridge patients with advanced heart failure to subsequent therapeutic stages. |
| Databáze: | OpenAIRE |
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