Device Therapy and Cardiac Transplantation for End-Stage Heart Failure
Section snippets
Background
An estimated 5.7 million people carry a diagnosis of heart failure in the USA (2006 figures), and almost 300,000 people die of heart failure in the USA each year.1 The prevalence of heart failure is increasing and increases with age.1 In the Western world, most heart failure is related to coronary disease, and although the survival of patients post acute myocardial infarction has improved, this has resulted in an increase in the numbers of patients ultimately developing heart failure.2 In fact,
A Brief History of Mechanical Support in Cardiac Failure
The development of cardiopulmonary bypass technology in the 1950s was the landmark achievement that greatly assisted the development of more permanent means of mechanical cardiac support.9 The first known mechanical support device dates back to Russia in the 1940s with the work of Dr. Vladimir Demikhov, who successfully implanted an artificial heart into a canine model, which supported the animal for over 5 hours.10 The first successful mechanical support device in humans was implanted by Dr.
Historical Perspective
Orthotopic cardiac transplantation as it exists today is a highly successful procedure for the treatment of end-stage heart disease and is the result of over 100 years of investigation and research.66 The concept of transplanting solid organs dates back to the 19th century, but the necessary surgical techniques were not developed until the 1890s, with the work of Alexis Carrel, who perfected a vascular anastomosis technique that allowed heterotopic transplantation of kidneys into the necks of
Conclusions
Cardiac replacement therapy in end-stage heart failure is at a crossroads. The art and science of cardiac transplant medicine has been perfected since the first transplant in 1967 and outcomes continue to improve. However, the number of transplants being performed worldwide is far outnumbered by the number of potential candidates, as donor hearts are a very limited resource. Advances in destination device therapy may provide a viable long-term solution for many patients, with either support of
Acknowledgments
The authors extend their thanks to the staff of the William J. Von Liebig Transplant Center and especially to Dr. Dylan V. Miller and Dr. Henry D. Tazelaar from the Department of Pathology for assistance with figures. The generous permission for use of figures and tables by the International Society for Heart and Lung Transplantation, and the incorporated companies of Thoratec, Jarvik Heart, Ventracor, Syncardia Systems, Abiomed, and Circulite, are gratefully appreciated. Last, the authors
References (298)
- et al.
Epidemiology of heart failure
Cardiol Clin
(2001) - et al.
Left ventricular assist devices as destination therapy: a new look at survival
J Thorac Cardiovasc Surg
(2005) - et al.
Care processes and clinical outcomes of continuous outpatient support with inotropes (COSI) in patients with refractory end stage heart failure
J Card Fail
(2003) - et al.
Heart failure-related hospitalization in the U.S., 1979-2004
J Am Coll Cardiol
(2008) - et al.
Review of ECMO (Extra Corporeal Membrane Oxygenation) support in critically ill adult patients
Heart Lung Circul
(2008) - et al.
A randomized clinical trial to evaluate the safety and efficacy of a percutaneous left ventricular assist device versus intra-aortic balloon pumping for treatment of cardiogenic shock caused by myocardial infarction
J Am Coll Cardiol
(2008) - et al.
Left ventricular support with the Impella LP 5.0 for cardiogenic shock following cardiac surgery
Heart Lung Circul
(2008) - et al.
Experience with the Levitronix CentriMag circulatory support system as a bridge to decision in patients with refractory acute cardiogenic shock and multisystem organ failure
J Thorac Cardiovasc Surg
(2007) - et al.
Bridge to decision using the Levitronix CentriMag short-term ventricular assist device
J Heart Lung Transplant
(2008) - et al.
Enhanced external counterpulsation improves exercise tolerance in patients with chronic heart failure
J Am Coll Cardiol
(2006)
Treating heart failure with enhanced external counterpulsation (EECP): design of the prospective evaluation of EECP in heart failure (PEECH) trial
J Card Fail
Chronic mechanical circulatory support for inotrope-dependent heart failure patients who are not transplant candidates: results of the INTrEPID Trial
J Am Coll Cardiol
End-organ function in patients on long-term circulatory support with continuous- or pulsatile-flow assist devices
J Heart Lung Transplant
Does total implantability reduce infection with the use of a left ventricular assist device?The LionHeart experience in Europe
J Heart Lung Transplant
Right heart failure after left ventricular assist device implantation in patients with chronic congestive heart failure
J Heart Lung Transplant
The right ventricular failure risk score a pre-operative tool for assessing the risk of right ventricular failure in left ventricular assist device candidates
J Am Coll Cardiol
Medically refractory pulmonary hypertension: treatment with nonpulsatile left ventricular assist devices
Ann Thorac Surg
Psychiatric aspects of cardiovascular disease
Psychiatr Clin North Am
Late-onset driveline infections: the Achilles' heel of prolonged left ventricular assist device support
Ann Thorac Surg
Comparisons of infection complications between continuous flow and pulsatile flow left ventricular assist devices
J Thorac Cardiovasc Surg
Gastrointestinal bleeding from arteriovenous malformations in patients supported by the Jarvik 2000 axial-flow left ventricular assist device
J Heart Lung Transplant
Platelet dysfunction in outpatients with left ventricular assist devices
Ann Thorac Surg
Low thromboembolic risk for patients with the Heartmate II left ventricular assist device
J Thorac Cardiovasc Surg
Pleural effusion after ventricular assist device placement: prevalence and pleural fluid characteristics
Chest
Use of the AbioCor replacement heart as destination therapy for end-stage heart failure with irreversible pulmonary hypertension
J Thorac Cardiovasc Surg
Initial experience with the AbioCor implantable replacement heart system
J Thorac Cardiovasc Surg
Left ventricular assist device support normalizes left and right ventricular beta-adrenergic pathway properties
J Am Coll Cardiol
Left ventricular assist device-induced reverse ventricular remodeling
Prog Cardiovasc Dis
The development of cardiac transplantation
Mayo Clin Proc
Registry of the international society for heart and lung transplantationTwenty-fourth official adult heart transplant report—2007
J Heart Lung Transplant
Registry of the international society for heart and lung transplantationTwenty-fifth official adult heart transplant report—2008
J Heart Lung Transplant
Improved survival of patients with end-stage heart failure listed for heart transplantation: analysis of organ procurement and transplantation network/U.S. United Network of Organ Sharing data, 1990-2005
J Am Coll Cardiol
An analysis of the effect of age on survival after heart transplant
J Heart Lung Transplant
Long-term results of cardiac transplantation in patients 65 years of age and older: a comparative analysis
Ann Thorac Surg
Panel-reactive antibody screening practices prior to heart transplantation
J Heart Lung Transplant
Cardiac rhythm disturbances early after orthotopic heart transplantation: prevalence and clinical importance of the observed abnormalities
J Am Coll Cardiol
Recent Development in Lung and Heart-Lung Transplantation
Orthotopic cardiac transplantation technique: a survey of current practice
Ann Thorac Surg
Induction therapy in heart transplantation: is there a role?
J Heart Lung Transplant
To induce or not to induce: do patients at greatest risk for fatal rejection benefit from cytolytic induction therapy?
J Heart Lung Transplant
Influence of induction therapy, immunosuppressive regimen and antiviral prophylaxis on development of lymphomas after heart transplantation: data from the Spanish Post-Heart Transplant Tumour Registry
J Heart Lung Transplant
Heart disease and stroke statistics, 2009 updateA report from the american heart association statistics committee and stroke statistics subcommittee
Circulation
Young adults with family history of coronary heart disease have increased arterial vulnerability to metabolic risk factors: the cardiovascular risk in young Finns study
Arterioscler Thromb Vasc Biol
Long-term mechanical left ventricular assistance for end-stage heart failure
N Engl J Med
The boomers are coming: a total cost of care model of the impact of population aging on the cost of chronic conditions in the United States
Dis Manag
Mechanical circulatory support registering a therapy in evolution circulation
Heart Fail
A surgeon to remember: notes about Vladimir Demikhov
Ann Thorac Surg
Clinical utility of TandemHeart for high-risk tandem procedures: percutaneous balloon aortic valvuloplasty followed by complex PCI
J Invasive Cardiol
High-risk left main coronary stenting supported by percutaneous Impella recover LP 2.5 assist device
J Invasive Cardiol
Feasibility and long-term safety of elective Impella-assisted high-risk percutaneous coronary intervention: a pilot two-centre study
J Cardiovasc Med
Cited by (48)
Intraoperative and Early Postoperative Management of Heart Transplantation: Anesthetic Implications
2020, Journal of Cardiothoracic and Vascular AnesthesiaCitation Excerpt :The presence of damage to the donor sinoatrial or atrioventricular nodes because of prolonged ischemic time or surgical trauma may lead to bradycardia or arrhythmias, requiring temporary pacing or direct β-agonist agents. Permanent pacing post-HT is required in 4% to 12% of HT recipients.77 Tricuspid valvular regurgitation is the most common single valvular dysfunction after HT.
Cardiovascular Medical Devices: Heart Valves, Pacemakers and Defibrillators, Mechanical Circulatory Support, and Other Intracardiac Devices
2020, Biomaterials Science: An Introduction to Materials in MedicineAnesthesia for Heart Transplantation
2017, Anesthesiology ClinicsCitation Excerpt :Prolonged ischemic time also can damage the SA or atrioventricular node, which may prolong the need for chronotropic infusions or necessitate permanent pacing. Permanent pacing is required in 4% to 12% of transplanted hearts due to sinus node dysfunction.70 Early rejection is divided into acute and hyperacute based on pathology.
The Pathology of Cardiovascular Interventions and Devices for Coronary Artery Disease, Vascular Disease, Heart Failure, and Arrhythmias
2016, Cardiovascular Pathology: Fourth Edition
The authors have no conflicts to disclose.