A continuous-flow external ventricular assist device for cardiogenic shock: Evolution over 10 years

The Journal of Thoracic and Cardiovascular Surgery

Arthur R. Garan¹  Masahiko Ando² 

[1] Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY;Division of Cardiothoracic Surgery, Department of Surgery, Columbia University Medical Center, New York, NY

关键词: cardiogenic shock;    extracorporeal membrane oxygenation;    ventricular assist device;    outcome;    bridge;   

DOI  :  10.1016/j.jtcvs.2017.12.148

学科分类：心脏病和心血管学

来源: Mosby, Inc.

【 摘 要 】

BackgroundThe use of percutaneous mechanical circulatory support (MCS) in the treatment of cardiogenic shock has increased. However, limitations in flow capability, ventricular unloading effect, durability, and mobility remain. We reviewed our single-center experience with continuous-flow external ventricular assist devices (VADs) to determine the role of temporary VADs for cardiogenic shock in the contemporary MCS era.MethodsWe retrospectively reviewed 252 patients who underwent continuous-flow external VAD insertion between January 2007 and December 2016. To investigate the change in indications, device configurations, and outcomes, we divided the cohort into 2 groups—2007 to 2011 (Era 1; n = 127) and 2012 to 2016 (Era 2; n = 125)—and compared early and late outcomes.ResultsIndications and device configurations changed significantly over time. The use of preoperative percutaneous MCS (53% vs 23%; P P P = .04). Overall survival at 1 year was 57% in Era 2 versus 43% in Era 1 (P = .04).ConclusionsBetter outcomes in the recent era could be associated with the changes in practice patterns using continuous-flow external VAD in patients with refractory cardiogenic shock.

【 授权许可】

Unknown