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Tex Heart Inst J. 2008;35(3):340-1.

Bridge to transplantation with the TandemHeart: bending the indications in a chronic aortic dissection patient with postcardiotomy shock.

Author information

1
Department of Cardiopulmonary Transplantation and Mechanical Circulatory Support, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77225-0345, USA.

Abstract

Herein, we report a successful bridge to heart transplantation by use of the TandemHeart percutaneous ventricular assist device (pVAD) in a chronic aortic dissection patient who was experiencing postcardiotomy shock. The patient had undergone an aortocoronary bypass to treat an acute, extensive myocardial infarction that had resulted from severe stenosis of a Cabrol-like graft to the left main coronary artery. The TandemHeart was used successfully, despite classic contraindications for pVAD support. The outcome shows that, in critically ill cardiogenic shock patients, a permissive approach to pVAD use is valuable in screening candidates for long-term ventricular assist device support or for heart transplantation. This case also reveals the validity of direct bridging to transplantation from a pVAD in carefully selected patients.

KEYWORDS:

Aneurysm, dissecting; aortic aneurysm/mortality/surgery; cardiac output/physiology; heart transplantation; heart-assist devices; myocardial infarction/etiology; postoperative complications; shock, cardiogenic/therapy; treatment outcome; ventricular dysfunction, left/physiopathology/therapy

PMID:
18941602
PMCID:
PMC2565541
[Indexed for MEDLINE]
Free PMC Article
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