PMID- 19465866
OWN - NLM
STAT- MEDLINE
DCOM- 20091015
LR  - 20090826
IS  - 1558-2027 (Print)
IS  - 1558-2027 (Linking)
VI  - 10
IP  - 10
DP  - 2009 Oct
TI  - Heartmate II axial-flow left ventricular assist system: management, clinical 
      review and personal experience.
PG  - 765-71
LID - 10.2459/JCM.0b013e32832d495e [doi]
AB  - OBJECTIVES: The excellent results with left ventricular assist devices (LVADs) 
      have revolutionized the treatment options for end-stage heart failure. The use of 
      pulsatile devices is associated with significant comorbidity and limited 
      durability. The axial-flow HeartMate II LVAD represents the new generation of 
      devices. The clinical use of this pump resulted in superior outcomes. We review 
      the HeartMate II technology, management, clinical usage and our experience. 
      METHODS: Between 3/2002 and 12/2008, 18 transplantable adult patients were 
      supported on long-term HeartMate II LVAD at our institution (13 men, age 52 +/- 
      8.4 years, range: 31-64 years). Primary indications were: ischemic cardiomyopathy 
      (CMP) (n = 13), idiopathic CMP (n = 5). All patients were in New York Heart 
      Association (NYHA) Class IV heart failure. None of patients had prior open-heart 
      surgery. Implantation via cannulation of the left ventricular apex and the 
      ascending aorta was always elective. RESULTS: Mean support time was 217 +/- 212.3 
      days (range: 1-665 days). Early (30-day) mortality was 27.7% (five patients) with 
      multiple organ failure and sepsis as main causes of death. Bleeding requiring 
      reoperation occurred in six (33.3%) cases. Cerebral hemorrhage occurred in one 
      patient. There were two driveline infections and no device failure. Twelve 
      (66.6%) patients were successfully discharged home. Overall nine patients (50%) 
      were transplanted and two patients are actually waiting for a suitable organ (n = 
      2 patients discharged home and n = 1 patient in hospital). At latest, follow-up 
      survival rate after heart transplantation is 66.6% (six patients). CONCLUSION: 
      Long-term HeartMate II LVAD provides good mid-term, long-term results. This new 
      technology requires delicate management. Functional status and quality of life 
      greatly improve in patients who survive the perioperative period.
FAU - Loforte, Antonino
AU  - Loforte A
AD  - Department of Cardiac Surgery and Heart Transplantation, San Camillo Hospital, 
      Rome, Italy. antonioloforte@yahoo.it
FAU - Montalto, Andrea
AU  - Montalto A
FAU - Ranocchi, Federico
AU  - Ranocchi F
FAU - Casali, Giovanni
AU  - Casali G
FAU - Luzi, Giampaolo
AU  - Luzi G
FAU - Monica, Paola Lilla Della
AU  - Monica PL
FAU - Sbaraglia, Fabio
AU  - Sbaraglia F
FAU - Polizzi, Vincenzo
AU  - Polizzi V
FAU - Distefano, Giada
AU  - Distefano G
FAU - Musumeci, Francesco
AU  - Musumeci F
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Cardiovasc Med (Hagerstown)
JT  - Journal of cardiovascular medicine (Hagerstown, Md.)
JID - 101259752
SB  - IM
MH  - Adult
MH  - Cardiomyopathies/mortality/physiopathology/*therapy
MH  - Equipment Design
MH  - Female
MH  - *Heart-Assist Devices
MH  - Hemodynamics
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Treatment Outcome
EDAT- 2009/05/26 09:00
MHDA- 2009/10/16 06:00
CRDT- 2009/05/26 09:00
PHST- 2009/05/26 09:00 [entrez]
PHST- 2009/05/26 09:00 [pubmed]
PHST- 2009/10/16 06:00 [medline]
AID - 10.2459/JCM.0b013e32832d495e [doi]
PST - ppublish
SO  - J Cardiovasc Med (Hagerstown). 2009 Oct;10(10):765-71. doi: 
      10.2459/JCM.0b013e32832d495e.