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Optimal, Early Postoperative Management of Cardiac Transplant and Durable Left Ventricular Assist Recipients

  • Heart Failure (HJ Eisen, Section Editor)
  • Published:
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Abstract

Purpose of Review

Summarize developments in the early postoperative care of patients undergoing cardiac transplantation or left ventricular assist device implantation. Provide a practical approach with personal insights to highly complex patients at risk for prolonged hospitalization.

Recent Findings

Advancements in technology allow for percutaneous mechanical circulatory support of both the right and left ventricles either isolated or combined via subclavian and neck vessels. Since the adult heart allocation system has been changed to reduce waitlist mortality, the use of temporary mechanical circulatory support has increased. This has influenced preoperative optimization by enabling ambulation and majorly changed postoperative strategy. New doors have been opened for a multidisciplinary approach to facilitate rapid weaning of inotropic medications, limitation of sedation, early liberation from mechanical ventilation, and mobilization.

Summary

Individualized percutaneous mechanical circulatory support offers new possibilities for the early postoperative management of highly complex patients undergoing cardiac transplantation or durable left ventricular assist device implantation.

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Authors and Affiliations

  1. Heart and Vascular Institute Critical Care Unit and Adult ECMO and Mechanical Circulatory Support Program, Penn State University College of Medicine, Hershey, PA, 17033, USA

    Miriam Freundt & Christoph Brehm

  2. Penn State College of Medicine, Hershey, USA

    Elizabeth Lavanga

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  1. Miriam Freundt
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Correspondence to Miriam Freundt.

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Freundt, M., Lavanga, E. & Brehm, C. Optimal, Early Postoperative Management of Cardiac Transplant and Durable Left Ventricular Assist Recipients. Curr Cardiol Rep 24, 2023–2029 (2022). https://doi.org/10.1007/s11886-022-01823-0

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