LVAD Use in the Treatment of End-Stage Heart Failure

  • B. M. Todurov Heart Institute of the Ministry of Health of Ukraine, Kyiv, Ukraine; Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine https://orcid.org/0000-0002-9618-032X
  • H. I. Kovtun Heart Institute of the Ministry of Health of Ukraine, Kyiv, Ukraine
  • A. O. Shpachuk Heart Institute of the Ministry of Health of Ukraine, Kyiv, Ukraine
  • I. N. Kuzmich Heart Institute of the Ministry of Health of Ukraine, Kyiv, Ukraine
  • A. N. Druzhina Heart Institute of the Ministry of Health of Ukraine, Kyiv, Ukraine; Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine
  • S. N. Sudakevich Heart Institute of the Ministry of Health of Ukraine, Kyiv, Ukraine; Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine https://orcid.org/0000-0002-9253-9593
  • A. Y. Melnik Heart Institute of the Ministry of Health of Ukraine, Kyiv, Ukraine
Keywords: mechanical support of blood circulation, dilated cardiomyopathy, chronic heart failure

Abstract

Circulatory failure, developing at a certain stage of the course of most heart diseases, is a progressive process, associated with high morbidity and mortality. The effectiveness of generally accepted conservative and resynchronizing therapy for disease progression is relatively low. Mortality of patients with clinically severe congestive heart failure (CHF) reaches 26-29% within a one year after diagnosis. Thus, heart transplantation is the main option for patients with endstage heart failure. About 5,000 heart transplants are performed annually in the world, with 95% of them occurring in North America and Western Europe. But even in countries with a high level of transplantation activity, donor organs of the required quality are still sorely lacking. In such a situation, the main alternative to transplantation may be the use of artificial heart ventricles usually called as ventricular assist device (VAD). In the long run, VAD therapy can serve as a tool for healing (“bridge to recovery”), as a tool of awaiting of further transplantation (“bridge to transplantation”), or as a destination therapy. The article presents the experience of using VAD (in the form of left ventricular bypass) in five patients with end-stage CHF. In order to replace the function of the heart LV, a miniature implant system for auxiliary blood circulation INCOR VAD (Berlin Heart GmbH, Berlin, Germany) was used. Our experience from 5 cases has successfully demonstrated that the implantation of a system for long-term mechanical support of the heart to patients with progressive heart failure can be an effective method of treatment that can safely extend the waiting time for heart transplantation.

References

  1. Kirklin JK, Pagani FD, Kormos RL, Stevenson LW, Blume ED, Myers SL, Miller MA, Baldwin JT, Young JB, Naftel DC. Eighth annual INTERMACS report: Special focus on framing the impact of adverse events. J. Heart Lung Transplant. 2017 Oct;36(10):1080–6. https://doi.org/10.1016/j.healun.2017.07.005
  2. Kirklin JK, Naftel DC, Pagani FD, Kormos RL, Stevenson LW, Blume ED, Miller MA, Baldwin JT, Timothy Baldwin J, Young JB. Sixth INTERMACS annual report: a 10,000-patient database. J. Heart Lung Transplant. 2014 Jun;33(6):555–64. https://doi.org/10.1016/j.healun.2014.04.010
  3. Jakovljevic DG, Yacoub MH, Schueler S, MacGowan GA, Velicki L, Seferovic PM, Hothi S, Tzeng BH, Brodie DA, Birks E, Tan LB. Left Ventricular Assist Device as a Bridge to Recovery for Patients With Advanced Heart Failure. J. Am. Coll. Cardiol. 2017 Apr 18;69(15):1924–33. https://doi.org/10.1016/j.jacc.2017.02.018
  4. Feldman D, Pamboukian SV, Teuteberg JJ, Birks E, Lietz K, Moore SA, Morgan JA, Arabia F, Bauman ME, Buchholz HW, Deng M, Dickstein ML, El-Banayosy A, Elliot T, Goldstein DJ, Grady KL, Jones K, Hryniewicz K, John R, Kaan A, Kusne S, Loebe M, Massicotte MP, Moazami N, Mohacsi P, Mooney M, Nelson T, Pagani F, Perry W, Potapov EV, Eduardo Rame J, Russell SD, Sorensen EN, Sun B, Strueber M, Mangi AA, Petty MG, Rogers J; International Society for Heart and Lung Transplantation. The 2013 International Society for Heart and Lung Transplantation Guidelines for mechanical circulatory support: executive summary. J Heart Lung Transplant. 2013 Feb;32(2):157–87. https://doi.org/10.1016/j.healun.2012.09.013
  5. Pratt AK, Shah NS, Boyce SW. Left ventricular assist device management in the ICU. Crit Care Med. 2014 Jan;42(1):158–68. https://doi.org/10.1097/01.ccm.0000435675.91305.76
  6. Cheng A, Williamitis CA, Slaughter MS. Comparison of continuous-flow and pulsatile-flow left ventricular assist devices: is there an advantage to pulsatility? Ann Cardio-thorac Surg. 2014;3:573–81. https://doi.org/10.3978/j.issn.2225-319X.2014.08.24
  7. Implantable system of ancillary circulation with Incor® device. Instructions for Clinical Use, version 3.5. p. 57–63. Russian.
Published
2020-05-26
How to Cite
Todurov, B. M., Kovtun, H. I., Shpachuk, A. O., Kuzmich, I. N., Druzhina, A. N., Sudakevich, S. N., & Melnik, A. Y. (2019). LVAD Use in the Treatment of End-Stage Heart Failure. Ukrainian Journal of Cardiovascular Surgery, (2 (39), 43-47. https://doi.org/10.30702/ujcvs/20.3905/031043-047