Treatment of Endstage Heart Disease With Mechanical Circulatory Assistance
スポンサーリンク
概要
- 論文の詳細を見る
A great number of patients suffer and die from the sequelae of acute and chronic heart failure each year. Although advances in medical and surgical therapy have benefited many of these patients, the majority suffer from disease refractory to any definitive therapy. For these patients, cardiac transplantation is the only remaining hope. Unfortunately, because of the increasing demand for donor organs in the face of a fixed and limited supply, this option is only available to a small percentage of these patients. Even in patients accepted for transplantation, a significant waiting list mortality has been observed. A variety of ventricular assist devices (VAD) have been developed since the first successful case of mechanical cardiac assistance over 30 years ago. These devices differ in basic mechanical function, method of insertion, and degree of implantability, and thus have different indications and potential applications. While the intra-aortic balloon pump and centrifugal pumps are effective short-term support modalities, extracorporeal and implantable pulsatile devices have been used successfully for long-term support of patients with reversible and non-reversible cardiac failure. These pumps have most commonly been utilized as bridges to transplantation, but increasing clinical experience has supported the notion of long-term mechanical assistance as a definitive therapy for endstage heart disease. While complications, particularly infection and thromboembolism, pose significant challenges and long-term device reliability remains to be fully determined, available implantable devices seem capable of providing effective long-term support. As data is obtained from currently ongoing trials comparing VAD support to medical therapy for endstage heart failure, ethical and economic issues will assume increasing importance. (Jpn Circ J 1997; 61: 887 -892)
- 社団法人 日本循環器学会の論文
社団法人 日本循環器学会 | 論文
- Adenosine Triphosphate Exposes Dormant Pulmonary Vein Conduction Responsible for Recurrent Atrial Tachyarrhythmias : Importance of Evaluating the Dormant Conduction During the Re-Do Ablation Procedure
- Impact of Diabetes Mellitus on Rehospitalization for Heart Failure Among Survivors of Acute Myocardial Infarction in the Percutaneous Coronary Intervention Era
- N-Acetylcysteine Reduces the Severity of Atherosclerosis in Apolipoprotein E-Deficient Mice by Reducing Superoxide Production
- Incremental Effects of Eicosapentaenoic Acid on Cardiovascular Events in Statin-Treated Patients With Coronary Artery Disease : Secondary Prevention Analysis From JELIS
- Risk of Smoking and Metabolic Syndrome for Incidence of Cardiovascular Disease : Comparison of Relative Contribution in Urban Japanese Population : The Suita Study