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Pathological Considerations in Temporary Cardiac Assistance

  • Conference paper
Assisted Circulation 3

Abstract

Short-term circulatory support has been provided successfully with both ventricular assist devices (VADs) and total artificial hearts (TAHs). Of the approximately 1% of adult patients who develop severe cardiogenic shock following otherwise uncomplicated cardiac surgery, ventricular recovery (and hospital discharge) has been reported in as many as 40%-45% of those treated by aggressive temporary mechanical support [1]. Cardiac function and quality of life are excellent in long-term survivors [2, 3]. Due to the limited availability of donor organs for cardiac transplantation, many candidates succumb before a suitable donor organ becomes available. A number of these severely ill patients have survived until (and following) their transplants with the aid of a mechanical support device implanted in the face of precipitous hemodynamic decline [4, 5]. Thus, experience with temporary cardiac assistance (TCA) has accumulated in two groups of patients: (a) those in postcardiotomy cardiogenic shock, in whom the objective is ventricular recovery; and (b) those needing a “bridge” to transplantation, when no ventricular recovery is expected; in this situation, the goal is hemodynamic support of the patient until cardiac replacement may be done with a donor heart. Although there is a potential role of temporary ventricular support in patients with cardiogenic shock due to acute myocardial infarction, clinical experience with TCA done for this indication is extremely limited.

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Authors
  1. F. J. Schoen
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  2. W. F. Bernhard
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Editors and Affiliations

  1. Herzchirurgie Salzburg, Landeskrankenanstalten, Müllner Hauptstr. 48, A-5020, Salzburg, Austria

    Felix Unger

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© 1989 Springer-Verlag Berlin Heidelberg

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Schoen, F.J., Bernhard, W.F. (1989). Pathological Considerations in Temporary Cardiac Assistance. In: Unger, F. (eds) Assisted Circulation 3. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-74404-4_9

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  • DOI: https://doi.org/10.1007/978-3-642-74404-4_9

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-74406-8

  • Online ISBN: 978-3-642-74404-4

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