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Long-term follow-up of patients treated with an implantable left ventricular assist device as an extended bridge to heart transplantation
Linköping University, Department of Medicine and Health Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
Linköping University, Department of Medicine and Health Sciences, Thoracic Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
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2002 (English)In: The Journal of Heart and Lung Transplantation, ISSN 1053-2498, Vol. 21, no 5, 604-607 p.Article in journal (Refereed) Published
Abstract [en]

Four patients were given the TCI implantable left ventricular assist device as a bridge to heart transplantation. The median treatment time was 541 days (range 462 to 873 days), with a total of 2,417 treatment days. The patients were followed with exercise tests and echocardiography 3 to 18 months after implantation. An invasive method was used for quantification of inflow valve incompetence.

Place, publisher, year, edition, pages
2002. Vol. 21, no 5, 604-607 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-13611DOI: 10.1016/S1053-2498(01)00372-2OAI: oai:DiVA.org:liu-13611DiVA: diva2:21054
Available from: 2001-06-12 Created: 2001-06-12 Last updated: 2009-08-20
In thesis
1. Management of patients treated with left ventricular assist devices: A clinical and experimental study
Open this publication in new window or tab >>Management of patients treated with left ventricular assist devices: A clinical and experimental study
2001 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis describes the management of patients treated with mechanical circulatory support devices for short- or long-term use. Twenty-four patients suffering from postcardiotomy heart failure were treated with a minimally invasive axial flow pump. The device was effective in unloading the failing left ventricle and in maintaining an adequate systemic circulation. The principles of perioperative monitoring, and pharmacological therapy are outlined. The pump was also used as an alternative to the heart-lung machine in conjunction with coronary artery bypass surgery. Together with a short-acting β-blocker, esmolol, the heart was decompressed and heart motion was reduced, facilitating bypass surgery on the beating heart. The anesthesiological considerations using this method are described.

An implantable left ventricular assist device was used as a bridge to heart transplantation in 10 patients. We were interested in assessing the possibility to establish such a treatment program at a non-transplanting center. A multidisciplinary approach was enabled thanks to the organization of our Heart Center and due the close collaboration with our transplant center at Lund University. As one of the first centers in Europe, we established a well-functioning program with good results. Nine out of 10 of the bridge patients, with treatment times varying between 53 to 873 days, survived pump treatment and were eventually transplanted. The device proved to be powerful enough to support the failing heart and enable rehabilitation of the patients. Outpatient management became simpler when using the electrical device with belt-worn batteries. The uncertain durability and the high risk of device-related complications are shortcomings that limit its potential for more permanent treatment of heart failure.

A new generation of small implantable axial blood flow pumps has therefore been developed. The principles of these pumps are based on the first generation axial flow pumps evaluated in this thesis. After several years of basic research and experimental studies, the first human implants have been performed. In the thesis, the hemodynamic effects of such a novel axial flow pump have been evaluated in an acute heart failure model. This technology holds great promise, both as a bridge to heart transplantation, and as a permanent circulatory support system.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2001. 79 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 677
Keyword
postcardiotomy heart failure, perioperative monitoring, coronary artery bypass, heart-assist devices, heart failure, congestive, ventricular dysfunction
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-5151 (URN)91-7219-969-5 (ISBN)
Public defence
2001-05-21, Berzeliussalen, Campus US, Linköpings universitet, Linköping, 00:00 (English)
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Note
On the day of the public defence the status of the article IV was: Submitted for publication.Available from: 2001-06-12 Created: 2001-06-12 Last updated: 2012-01-24Bibliographically approved

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Peterzén, BengtJansson, KjellRuthberg, HansCasimir Ahn, HansNylander, Eva

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Peterzén, BengtJansson, KjellRuthberg, HansCasimir Ahn, HansNylander, Eva
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Department of Medicine and Health SciencesFaculty of Health SciencesDepartment of Thoracic and Vascular SurgeryCardiology Department of CardiologyThoracic SurgeryClinical Physiology Department of Clinical Physiology
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