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Klinische Indikationskriterien für mechanische Kreislaufunterstützung

Clinical criteria for mechanical circulatory support

  • ORIGINALARBEIT
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Zeitschrift für Herz-,Thorax- und Gefäßchirurgie Aims and scope

Zusammenfassung

Die mechanische Kreislaufunterstützung ist mittlerweile in spezialisierten Zentren im klinischen Alltag verfügbar. Jedoch gibt es keine allgemein gültigen Indikationskriterien für den Einsatz der verschiedenen Unterstützungssysteme. In dieser Arbeit wird ein Überblick über die verfügbaren Indikationskriterien gegeben. Aus den bisherigen Erfahrungen wird eine extrakorporale Membranoxygenierung vor allem unter Reanimationsbedingungen eingesetzt. Ein linksventrikuläres Unterstützungssystem findet bei erhaltener Rechtsventrikelfunktion seine Anwendung, bei bi-ventrikulärem Pumpversagen kommt ein bi-ventrikuläres Unterstützungssystem zum Einsatz. Das Total Artificial Heart wird bei Patienten mit fortgeschrittener Endorganschädigung implantiert.

Abstract

Mechanical circulatory support is available in numerous specialized centres. However, generally accepted clinical criteria for the use of mechanical support are not available. Within this work an overview concerning published clinical criteria is given. So far, extracorporeal membrane oxygenation is used mainly during resuscitation. Left ventricular support systems can be implanted if right ventricular function is preserved, in case of bi-ventricular failure the use of bi-ventricular mechanical circulatory support is indicated. Patients with profound end organ dysfunction require a Total Artificial Heart.

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Literatur

  1. Frazier OH, Delgado RM (2003) Mechanical circulatory support for advanced heart failure. Circulation 108:3064–3068

    Article  PubMed  CAS  Google Scholar 

  2. Hetzer R, Potapov EV, Huebler S (2006) Procedings of the 4th Berlin symposium on mechanical circulatory support. Berlin, Germany, December 9–10, 2005. J Card Surg 21:512–520

    Article  Google Scholar 

  3. Loisance D (2004) Cardiac assist devices: present status and future opportunities. Expert Rev Medical Devices 1:43–48

    Article  Google Scholar 

  4. Fynn-Thompson F, Almond C (2007) Pediatric ventricular assist devices. Pediatr Cardiol 9:76–80

    Google Scholar 

  5. Morales DL, Gunter KS, Fraser CD (2006) Pediatric mechanical circulatory support. Int J Artif Organs 29:920–937

    PubMed  CAS  Google Scholar 

  6. Hoefer D, Ruttmann E, Poelzl G, Kilo J, Hoermann C, Margreiter R, Laufer G, Antretter H (2006) Outcome evaluation of the bridge to bridge concept in patients with cardiogenic shock. Ann Thor Surg 82:28–34

    Article  Google Scholar 

  7. Magliato KE, Kleisli T, Soukiasian HJ (2003) Biventricular support in patients with profound cardiogenic shock: a single center experience. ASAIO J 49:475–479

    PubMed  Google Scholar 

  8. Pagani FD, Aaronson KD, Swaniker F, Bartlett RH (2001) The use of extracorporeal life support in adult patients with primary cardiac failure as a bridge implantable left ventricular assist device. Ann Thor Surg 71:S77–81

    Article  CAS  Google Scholar 

  9. Potapov E, Weng Y, Hausmann H, Kopitz M, Pasic M, Hetzer R (2003) New approach in treatment of acute cardiogenic shock requiring mechanical circulatory support. Ann Thor Surg 76:2112–2114

    Article  Google Scholar 

  10. Smerida NG, Blackstone EH (2001) Postcardiotomy mechanical support: risk factors and outcome. Ann Thor Surg 71:S60–66

    Article  Google Scholar 

  11. Pennington DG, Smerida NG, Samuels LE, Acker MA, Curtis JJ, Pagani FD (2001) Mechanical circulatory support for acute heart failure. Ann Thor Surg 71:S56–59

    Article  CAS  Google Scholar 

  12. Frazier OH, Kirklin JK (eds) (2006) ISHLT monograph series. Mechanical circulatory support. Volume 1. Elsevier Inc.

  13. Deng MC, Edwards LB, Hertz MI, Rowe AW, Keck BM, Kormos R, Naftel DC, Kirklin JK, Taylor DO (2005) Mechanical circulatory support device database of the International Society for Heart and Lung Transplantation: third annual report – 2005. J Heart Lung Transplant 24:1182–1187

    Article  PubMed  Google Scholar 

  14. Kirklin JK, Holman WL (2006) Mechanical circulatory support therapy as a bridge to transplant or recovery (new advances). Curr Opin Cardiol 21:120–126

    Article  PubMed  Google Scholar 

  15. Williams MR, Oz MC (2001) Indications and patient selection for mechanical ventricular assistance. Ann Thor Surg 71:S86–91

    Article  CAS  Google Scholar 

  16. Deng MC, Loebe M, El-Banayosy A, Gronda E, Jansen PJM, Vigano M, Wieselthaler GM, Reichart B, Vitali E, Pavie A, Mesana T, Loisance DY, Wheeldon DR, Portner PM (2001) Mechanical circulatory support for advanced heart failure. Effect of patient selection on outcome. Circulation 103:231–237

    PubMed  CAS  Google Scholar 

  17. Kavarana MN, Pessin-Minsley MS, Urtecho J, Catanese KA, Flannery M, Oz MC, Naka Y (2002) Right ventricular dysfunction and organ failure in left ventricular assist device recipients: a continuing problem. Ann Thor Surg 73:745–750

    Article  Google Scholar 

  18. Ochiai Y, McCarthy PM, Smerida NG, Banbury MK, Navia JL, Feng J, Hsu AP, Yeager ML, Buda T, Hoercher KJ, Howard MW, Takagaki M, Doi K, Fukamachi K (2002) Predictors of severe right ventricular failure after implantable left ventricular assist device insertion: analysis of 245 patients. Circulation 106[Suppl I]:I198–I202

    Article  PubMed  Google Scholar 

  19. El-Banayosy A, Koerfer R, Arusoglu L, Kizner L, Morshuis M, Milting H, Tenderich G, Fey O, Minami K (2001) Device and patient management in a bridge to transplant setting. Ann Thor Surg 71:S98–102

    Article  CAS  Google Scholar 

  20. Tsukui H, Teuteberg JT, McNamarra DM (2005) Biventricular assist device utilization for patients with morbid congestive heart failure: a justifiable strategy. Circulation 112(Suppl 9):565–572

    Google Scholar 

  21. Copeland JG, Smith RG, Arabia FA, Nolan PE, Mehta VK, McCArthy MS, Chisholm KA (2001) Comparison of the Cardiowest total artificial heart, the Novacor left ventricular assist system and the Thoratec ventricular assist system in bridge to transplantation. Ann Thor Surg 71:S92–97

    Article  Google Scholar 

  22. Klotz S, Naka Y, Oz MC, Burkhoff D (2005) Biventricular assist device-induced right ventricular reverse structural and functional remodelling. J Heart Lung Transplant 24:1195–1201

    Article  PubMed  Google Scholar 

  23. El-Banayosy A, Arusoglu L, Morshuis M, Kizner L, Tenderich G, Sarnowski P, Milting H, Koerfer R (2005) Cardiowest total artificial heart: Bad Oeynhausen experience. Ann Thor Surg 80:548–552

    Article  Google Scholar 

  24. Copeland JG, Smith RG, Arabia FA, Nolan PE, Sethi GK, Tsau PH, McClellan D, Slepian MJ (2004) Cardiac replacement with a total artificial heart as a bridge to transplantation. N Engl J Med 351:859–867

    Article  PubMed  CAS  Google Scholar 

  25. Gray NA, Selzman CH (2006) Current status of the total artificial heart. Am Heart J 152:4–10

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Klinische Abteilung für Herzchirurgie, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria

    D. Hoefer, H. Antretter & G. Laufer

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  1. D. Hoefer
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  2. H. Antretter
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  3. G. Laufer
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Correspondence to D. Hoefer.

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Hoefer, D., Antretter, H. & Laufer, G. Klinische Indikationskriterien für mechanische Kreislaufunterstützung. Z Herz- Thorax- Gefäßchir 21, 273–279 (2007). https://doi.org/10.1007/s00398-007-0600-6

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  • DOI: https://doi.org/10.1007/s00398-007-0600-6

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