Pediatric Implantable Left Ventricular Assist Device Experience
Sınan Sabit KocabeyoğluÜmit KervanErtekin Utku ÜnalDoğan Emre SertSerhat KocaKemal KavasoğluDenizhan BağrulFeyza Ayşenur PaçMustafa Paç
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Bridge to transplantation
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Left ventricular mechanical assist device (LVAD) support is well established as a bridge to transplantation and as an alternative to transplantation in patients with end-stage heart failure. There are currently various LVAD systems available based on different types of pump technology. We present the VentrAssist LVAD, a centrifugal pump, and focus on a surgical implantation technique that may help reduce the complications typically associated with VAD surgery.412 patients underwent VentrAssist LVAD implantation between June 2003 and January 2009 worldwide. The overall rate of success was 81 % (i.e., ongoing, HTX, or recovery). Interestingly hemolysis is greatly reduced with this intracorporeal centrifugal LVAD compared to other VAD systems with other pump designs. Our surgical implantation technique and strategy may contribute to reducing complications.The VentrAssist is a powerful and effective LVAD; its use can considerably reduce hemolysis. Long-term follow-up is necessary to determine whether the VentrAssist is appropriate as a bridge to transplant as well as feasible for long-term application.
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The total artificial heart (TAH) is a form of mechanical circulatory support in which the patient's native ventricles and valves are explanted and replaced by a pneumatically powered artificial heart. Currently, the TAH is approved for use in end-stage biventricular heart failure as a bridge to heart transplantation. However, with an increasing global burden of cardiovascular disease and congestive heart failure, the number of patients with end-stage heart failure awaiting heart transplantation now far exceeds the number of available hearts. As a result, the use of mechanical circulatory support, including the TAH and left ventricular assist device (LVAD), is growing exponentially. The LVAD is already widely used as destination therapy, and destination therapy for the TAH is under investigation. While most patients requiring mechanical circulatory support are effectively treated with LVADs, there is a subset of patients with concurrent right ventricular failure or major structural barriers to LVAD placement in whom TAH may be more appropriate. The history, indications, surgical implantation, post device management, outcomes, complications, and future direction of the TAH are discussed in this review.
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Introduction. Implantation of the new-generation left ventricular assist device (LVAD) is an efficient therapeutic option as a bridge to transplantation in adults, as well as in children and adolescents with small body surface. The aim of this work was to present a case of a successful surgical treatment of terminal heart failure in a male adolescent who had an LVAD implanted as a bridge to heart transplantation. Case outline. The patient, a 17-year-old male, was admitted with the end-stage heart failure due to the dilated cardiomyopathy and implanted LVAD. Fourteen months after LVAD implantation, a successful ?second stage? surgical procedure was performed ? orthotopic heart transplantation preceded by the LVAD explantation. Conclusion. Long-term mechanical circulatory support is an effective and safe method in treatment of the end-stage heart failure as a bridge to transplantation in the adolescent period.
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The left ventricular assist device originated as a means to provide temporary circulatory support for patients suffering from end-stage heart failure. The device was originally intended to serve as a bridge to cardiac transplantation. Increasingly, however, the left ventricular assist device is being utilized as a destination therapy for those patients who are not candidates for heart transplantation. It is this utilization as a destination therapy that raises additional significant ethical concern related to the risks and benefits of the devices, factors influencing quality of life, and consequences pertaining to end-of-life care.
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Introduction: For the patients awaiting cardiac transplantation, mechanical circulatory support has been widely utilized in the form of left ventricular assist device or total artificial heart. Both total artificial heart and left ventricular assist device have been approved for the use as a bridge to transplantation therapy; however only left ventricular assist device has been approved for use as the destination therapy. The purpose of this review is to establish, using this literature, the possibility for the artificial heart transplant to be used as destination therapy besides highlighting the recent developments in this area of research in order to narrate the future of artificial heart transplantation. You can submit your Manuscripts at: https://symbiosisonlinepublishing.com/submitManuscript.php
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