PMID- 24392937
OWN - NLM
STAT- MEDLINE
DCOM- 20150309
LR  - 20140721
IS  - 1525-1594 (Electronic)
IS  - 0160-564X (Linking)
VI  - 38
IP  - 7
DP  - 2014 Jul
TI  - Use of left ventricular assist device (HeartMate II): a Singapore experience.
PG  - 543-8
LID - 10.1111/aor.12247 [doi]
AB  - Recent advances in medical and device therapies in heart failure have improved 
      the survival of patients with heart failure. However, due to the limited 
      availability of suitable heart donors, left ventricular assist devices (LVADs) 
      have become an important tool as a bridge-to-heart transplantation for patients 
      with refractory heart failure in Singapore. We report our experience with the 
      HeartMate II (HMII) LVAD (Thoratec Corporation, Pleasanton, CA, USA) as a 
      bridge-to-heart transplant in our center from 2009 to 2012. This was a 
      retrospective review of 23 consecutive patients who underwent HMII LVAD 
      implantation in our center between May 2009 and December 2012. All patients were 
      classified as Interagency Registry for Mechanically Assisted Circulatory Support 
      (INTERMACS) levels 1 to 3 and underwent LVAD implantation as a bridge-to-heart 
      transplant. There were 17 male and 6 female patients. The mean age was 43.6 years 
      old (range 14 to 64). The etiologies of heart failure included ischemic heart 
      disease [8], idiopathic dilated cardiomyopathy [11], viral myocarditis [2], and 
      chemotherapy-induced cardiomyopathy [2]. Nine patients were INTERMACS level 1, 12 
      patients level 2, and two patients level 3. All patients successfully underwent 
      HMII LVAD implantation. There was no mortality within the first 30 postoperative 
      days. Postoperative complications included stroke with full neurological recovery 
      (21.7%), mediastinal infection (21.7%), cardiac tamponade or mediastinal 
      collection requiring reopening of the chest (39.1%), cardiac arrhythmia (13.0%), 
      and pump thrombosis with pump replacement (4.3%). All patients were discharged 
      from hospital after LVAD implantation. Three patients experienced driveline 
      infections during outpatient follow-up. There were 19 readmissions due to the 
      following conditions: sub-therapeutic anticoagulation (13.0%), gastrointestinal 
      bleeding (13.0%), suspected pump thrombosis (13.0%), transient ischemic attack 
      (8.7%), arrhythmia (8.7%), congestive cardiac failure due to severe aortic 
      regurgitation (8.7%), right ventricular failure (4.3%), rhabdomyolysis (4.3%), 
      and hematuria (4.3%). Post-LVAD implantation, 20 patients were functionally New 
      York Heart Association (NYHA) class I, while 3 reported NYHA III symptoms. Three 
      patients were successfully bridged to heart transplantation. One patient was 
      successfully explanted 11 months after LVAD implantation. There were two 
      mortalities during the follow-up period. The average duration of LVAD support was 
      522 days (range 47 to 1316 days). The HeartMate II LVAD has proven to be 
      effective in our Asian population. Driveline infection rate remains low even in 
      the tropical hot, humid climate in Singapore. With more patients ending up on 
      extended periods of LVAD support, increased emphasis in the detection and 
      management of long-term complications of ventricular assist devices will be 
      needed.
CI  - Copyright (c) 2014 International Center for Artificial Organs and Transplantation 
      and Wiley Periodicals, Inc.
FAU - Lim, Choon Pin
AU  - Lim CP
AD  - National Heart Centre Singapore, Singapore.
FAU - Sivathasan, Cumaraswamy
AU  - Sivathasan C
FAU - Tan, Teing Ee
AU  - Tan TE
FAU - Lim, Chong Hee
AU  - Lim CH
FAU - Kerk, Ka Lee
AU  - Kerk KL
FAU - Sim, David Kheng Leng
AU  - Sim DK
LA  - eng
PT  - Journal Article
DEP - 20140107
PL  - United States
TA  - Artif Organs
JT  - Artificial organs
JID - 7802778
SB  - IM
CIN - Artif Organs. 2014 Jun;38(6):521-3. PMID: 24889668
MH  - Adolescent
MH  - Adult
MH  - Cohort Studies
MH  - Female
MH  - Heart Failure/epidemiology/*surgery/therapy
MH  - Heart Transplantation
MH  - *Heart-Assist Devices/adverse effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/epidemiology/therapy
MH  - Singapore/epidemiology
MH  - Young Adult
OTO - NOTNLM
OT  - Asia
OT  - Heart failure
OT  - HeartMate II
OT  - Left ventricular assist device
OT  - Singapore
EDAT- 2014/01/08 06:00
MHDA- 2015/03/10 06:00
CRDT- 2014/01/08 06:00
PHST- 2014/01/08 06:00 [entrez]
PHST- 2014/01/08 06:00 [pubmed]
PHST- 2015/03/10 06:00 [medline]
AID - 10.1111/aor.12247 [doi]
PST - ppublish
SO  - Artif Organs. 2014 Jul;38(7):543-8. doi: 10.1111/aor.12247. Epub 2014 Jan 7.