Langzeitanwendung der biventrikulären Kreislaufunterstützung typ Berlin Heart

Translated title of the contribution: Long-term support of the Biventricular Assist Device Berlin Heart

T. Drews, Matthias Loebe, M. Jurmann, R. Zu Dohna, E. Beyer, S. Holinsky, R. Hetzer

Research output: Contribution to journalArticle

Abstract

As transplant waiting times have lengthened, the need for long-term mechanical support has grown. In patients presenting with severe cardiogenic shock evolving multiorgan failure, we use the Berlin Heart biventricular support system. We describe 33 patients who were on BVAD support for more than 150 days. There were 27 male (82%) and 6 female (18%) with a mean age of 45 ± 10.7 years (range 24-62 years). The indication for BVAD was dilated in 24 cases, restrictive in 3 cases, and ischemic cardiomyopathies in 6 cases. These patients were followed for infections, thromboembolic events, bleeding complications, and psychologic effect of BVAD placement. Our experience shows that 32 patients (97%) recovered completely from secondary organ dysfunction. This was required prior to heart transplantation. After 120 days, infections of the transcutaneous canula site were common. Coagulase negative staphylococcus was the most common cultured microbacteria. With appropriate antibiotic therapy, this did not preclude transplantation. The paracorporeally placed heparine-coated transparent polyurethane chambers are inspected daily for fibrin formation. If any formations are noted, the device is changed or cleaned. With an aggressive anticoagulation and antiaggregation protocol, the thromboembolic and bleeding events are minimized. Eleven patients (33%) died after a mean duration of 303 days (range 150-552 days) while waiting for transplant: two died from intracranial bleeding, seven from sepsis, one from a non-related cause (amyloidose) and one patient from a traumatic accident by sexual activity. Two patients (6%) are presently waiting for transplant with BVAD and twenty patients (60%) were transplanted after a mean time of 286 days (range 152-571 days). The results of heart transplant following long-term BVAD application were acceptable. Only three patients died. Twenty-one patients were discharged home with BVADs while awaiting transplant.

Original languageGerman
Pages (from-to)214-220
Number of pages7
JournalZeitschrift fur Herz-, Thorax- und Gefasschirurgie
Volume15
Issue number5
DOIs
StatePublished - 2001
Externally publishedYes

Fingerprint

Heart-Assist Devices
Berlin
Transplants
Hemorrhage
Polyurethanes
Cardiogenic Shock
Coagulase
Heart Transplantation
Infection
Fibrin
Cardiomyopathies
Staphylococcus
Sexual Behavior
Accidents
Sepsis
Transplantation
Anti-Bacterial Agents
Equipment and Supplies

Keywords

  • Biventricular assist device
  • Cardiomyopathy
  • Heart failure
  • Heart transplantation
  • Mechanical circulatory support

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Langzeitanwendung der biventrikulären Kreislaufunterstützung typ Berlin Heart. / Drews, T.; Loebe, Matthias; Jurmann, M.; Zu Dohna, R.; Beyer, E.; Holinsky, S.; Hetzer, R.

In: Zeitschrift fur Herz-, Thorax- und Gefasschirurgie, Vol. 15, No. 5, 2001, p. 214-220.

Research output: Contribution to journalArticle

Drews, T. ; Loebe, Matthias ; Jurmann, M. ; Zu Dohna, R. ; Beyer, E. ; Holinsky, S. ; Hetzer, R. / Langzeitanwendung der biventrikulären Kreislaufunterstützung typ Berlin Heart. In: Zeitschrift fur Herz-, Thorax- und Gefasschirurgie. 2001 ; Vol. 15, No. 5. pp. 214-220.
@article{5b6c8a26ced045e895675ea52209e7b2,
title = "Langzeitanwendung der biventrikul{\"a}ren Kreislaufunterst{\"u}tzung typ Berlin Heart",
abstract = "As transplant waiting times have lengthened, the need for long-term mechanical support has grown. In patients presenting with severe cardiogenic shock evolving multiorgan failure, we use the Berlin Heart biventricular support system. We describe 33 patients who were on BVAD support for more than 150 days. There were 27 male (82{\%}) and 6 female (18{\%}) with a mean age of 45 ± 10.7 years (range 24-62 years). The indication for BVAD was dilated in 24 cases, restrictive in 3 cases, and ischemic cardiomyopathies in 6 cases. These patients were followed for infections, thromboembolic events, bleeding complications, and psychologic effect of BVAD placement. Our experience shows that 32 patients (97{\%}) recovered completely from secondary organ dysfunction. This was required prior to heart transplantation. After 120 days, infections of the transcutaneous canula site were common. Coagulase negative staphylococcus was the most common cultured microbacteria. With appropriate antibiotic therapy, this did not preclude transplantation. The paracorporeally placed heparine-coated transparent polyurethane chambers are inspected daily for fibrin formation. If any formations are noted, the device is changed or cleaned. With an aggressive anticoagulation and antiaggregation protocol, the thromboembolic and bleeding events are minimized. Eleven patients (33{\%}) died after a mean duration of 303 days (range 150-552 days) while waiting for transplant: two died from intracranial bleeding, seven from sepsis, one from a non-related cause (amyloidose) and one patient from a traumatic accident by sexual activity. Two patients (6{\%}) are presently waiting for transplant with BVAD and twenty patients (60{\%}) were transplanted after a mean time of 286 days (range 152-571 days). The results of heart transplant following long-term BVAD application were acceptable. Only three patients died. Twenty-one patients were discharged home with BVADs while awaiting transplant.",
keywords = "Biventricular assist device, Cardiomyopathy, Heart failure, Heart transplantation, Mechanical circulatory support",
author = "T. Drews and Matthias Loebe and M. Jurmann and {Zu Dohna}, R. and E. Beyer and S. Holinsky and R. Hetzer",
year = "2001",
doi = "10.1007/s003980170018",
language = "German",
volume = "15",
pages = "214--220",
journal = "Zeitschrift fur Herz-, Thorax- und Gefasschirurgie",
issn = "0930-9225",
publisher = "D. Steinkopff-Verlag",
number = "5",

}

TY - JOUR

T1 - Langzeitanwendung der biventrikulären Kreislaufunterstützung typ Berlin Heart

AU - Drews, T.

AU - Loebe, Matthias

AU - Jurmann, M.

AU - Zu Dohna, R.

AU - Beyer, E.

AU - Holinsky, S.

AU - Hetzer, R.

PY - 2001

Y1 - 2001

N2 - As transplant waiting times have lengthened, the need for long-term mechanical support has grown. In patients presenting with severe cardiogenic shock evolving multiorgan failure, we use the Berlin Heart biventricular support system. We describe 33 patients who were on BVAD support for more than 150 days. There were 27 male (82%) and 6 female (18%) with a mean age of 45 ± 10.7 years (range 24-62 years). The indication for BVAD was dilated in 24 cases, restrictive in 3 cases, and ischemic cardiomyopathies in 6 cases. These patients were followed for infections, thromboembolic events, bleeding complications, and psychologic effect of BVAD placement. Our experience shows that 32 patients (97%) recovered completely from secondary organ dysfunction. This was required prior to heart transplantation. After 120 days, infections of the transcutaneous canula site were common. Coagulase negative staphylococcus was the most common cultured microbacteria. With appropriate antibiotic therapy, this did not preclude transplantation. The paracorporeally placed heparine-coated transparent polyurethane chambers are inspected daily for fibrin formation. If any formations are noted, the device is changed or cleaned. With an aggressive anticoagulation and antiaggregation protocol, the thromboembolic and bleeding events are minimized. Eleven patients (33%) died after a mean duration of 303 days (range 150-552 days) while waiting for transplant: two died from intracranial bleeding, seven from sepsis, one from a non-related cause (amyloidose) and one patient from a traumatic accident by sexual activity. Two patients (6%) are presently waiting for transplant with BVAD and twenty patients (60%) were transplanted after a mean time of 286 days (range 152-571 days). The results of heart transplant following long-term BVAD application were acceptable. Only three patients died. Twenty-one patients were discharged home with BVADs while awaiting transplant.

AB - As transplant waiting times have lengthened, the need for long-term mechanical support has grown. In patients presenting with severe cardiogenic shock evolving multiorgan failure, we use the Berlin Heart biventricular support system. We describe 33 patients who were on BVAD support for more than 150 days. There were 27 male (82%) and 6 female (18%) with a mean age of 45 ± 10.7 years (range 24-62 years). The indication for BVAD was dilated in 24 cases, restrictive in 3 cases, and ischemic cardiomyopathies in 6 cases. These patients were followed for infections, thromboembolic events, bleeding complications, and psychologic effect of BVAD placement. Our experience shows that 32 patients (97%) recovered completely from secondary organ dysfunction. This was required prior to heart transplantation. After 120 days, infections of the transcutaneous canula site were common. Coagulase negative staphylococcus was the most common cultured microbacteria. With appropriate antibiotic therapy, this did not preclude transplantation. The paracorporeally placed heparine-coated transparent polyurethane chambers are inspected daily for fibrin formation. If any formations are noted, the device is changed or cleaned. With an aggressive anticoagulation and antiaggregation protocol, the thromboembolic and bleeding events are minimized. Eleven patients (33%) died after a mean duration of 303 days (range 150-552 days) while waiting for transplant: two died from intracranial bleeding, seven from sepsis, one from a non-related cause (amyloidose) and one patient from a traumatic accident by sexual activity. Two patients (6%) are presently waiting for transplant with BVAD and twenty patients (60%) were transplanted after a mean time of 286 days (range 152-571 days). The results of heart transplant following long-term BVAD application were acceptable. Only three patients died. Twenty-one patients were discharged home with BVADs while awaiting transplant.

KW - Biventricular assist device

KW - Cardiomyopathy

KW - Heart failure

KW - Heart transplantation

KW - Mechanical circulatory support

UR - http://www.scopus.com/inward/record.url?scp=18344418087&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=18344418087&partnerID=8YFLogxK

U2 - 10.1007/s003980170018

DO - 10.1007/s003980170018

M3 - Article

AN - SCOPUS:18344418087

VL - 15

SP - 214

EP - 220

JO - Zeitschrift fur Herz-, Thorax- und Gefasschirurgie

JF - Zeitschrift fur Herz-, Thorax- und Gefasschirurgie

SN - 0930-9225

IS - 5

ER -