Mechanische Kreislaufunterstützung bei akuter und chronischer Herzinsuffizienz - eine Standortbestimmung unter besonderer Berücksichtigung der Entwicklung in Deutschland
Mechanical Circulatory Assist Devices in Acute and Chronic Heart FailureJ. Martin1
, M. P. Siegenthaler1
, M. Krause1
, O. Friesewinkel1
, F. Beyersdorf1
1Abteilung für Herz- und Gefäßchirurgie der Albert-Ludwigs-Universität, Freiburg im Breisgau
Der Einsatz mechanischer Kreislaufunterstützungssysteme, die vor allem zur Überbrückung der Wartezeit bis zur Herztransplantation Verwendung finden, hat sich bei vielen Patienten als lebensrettende Maßnahme erwiesen. In den letzten Jahren konnten die Kreislaufpumpen unter Berücksichtigung der klinischen Erfahrungen technisch erheblich weiterentwickelt werden. Die immer besseren Ergebnisse haben auch zu einer großzügigeren Indikationsstellung und breiteren Anwendung der sog. „Assist Devices ” geführt. Mit den Axialpumpen stehen heute Systeme zur Verfügung, die für einen langfristigen Einsatz konzipiert sind. Sollte es gelingen, die derzeitigen Probleme dieser Systeme (vor allem thromboembolische Komplikationen) deutlich zu reduzieren, könnten sie zukünftig eine Alternative zur Herztransplantation darstellen.
Abstract
The clinical use of mechanical circulatory assist devices as bridge to transplantation has been proved as life-saving therapy in a large population of patients. Learning from the clinical experience the construction of the blood pumps has been markedly improved over the last years. The better outcome of the patients has enabled a broader use of ventricular assist devices. The novel axial pumps are designed for long-term circulatory support. After further reduction of device related complications (first of all thromboembolic events) these systems may provide a future alternative to heart transplantation.
3
Copeland J G, Pavie A, Duveau D, Keon W J, Masters R, Pifarre R, Smith R G, Arabia F A.
Bridge to transplantation with the CardioWest total artificial heart: the international experience 1993-1995.
J Heart Lung Transplant.
1996;
15
94-99
4
Copeland J G, Smith R G, Arabia F A, Nolan P E, Mehta V K, McCarthy M S, Chisholm K A.
Comparison of the CardioWest total artificial heart, the Novacor left ventricular assist system and the thoratec ventricular assist system in bridge to transplantation.
Ann Thorac Surg.
2001;
71
92-97
6
DeRose J J, Umana J P, Argenziano M, Catanese K A, Levin H R, Sun B C, Rose E A, Oz M C.
Improved results for postcardiotomy cardiogenic shock with the use of implantable left ventricular assist devices.
Ann Thorac Surg.
1997;
64
1757-1762
8
Deng M C, Loebe M, El-Banayosy A, Gronda E, Jansen P GM, Vigano M, Wieselthaler G M, Reichart B, Vitali E, Pavie A, Mesana T, Loisance D Y, Wheeldon D R, Portner P M.
Mechanical circulatory support for advanced heart failure. Effect of patient selection on outcome.
Circulation.
2001;
103
231-237
9
DeVries W C, Anderson J L, Joyce L D, Anderson F C, Hammond E H, Jarvik R, Kolf W J.
Clinical use of the total artificial heart.
NEJM.
1984;
310
273-278
10
Dowling R K, Etoch S W, Stevens K A, Johnson A C, Gray L A.
Current status of the AbioCor implantable replacement heart.
Ann Thorac Surg.
2001;
71
147-149
12
El-Banayosy A, Deng M, Loisance D Y, Vetter H, Granda E, Loebe M, Vigano M.
The European experience of Novacor left ventricular assist (LVAS) therapy as a bridge to transplant: a retrospective multi-centre study.
Eur J Cardiothorac Surg.
1999;
15
835-841
13
El-Banayosi A, Arusoglu L, Kizner L, Tenderich G, Boethig D, Minami K, Körfer R.
Predictors of survival in patients bridged to transplantation with the thoratec VAD device: a single-center retrospective study on more than 100 patients.
J Heart Lung Transplant.
2000;
19
964-968
14
El-Banayosy A, Fey O, Sarnowski P, Arusoglu L, Boethig D, Milting K, Morshuis M, Körfer R.
Midterm follow-up of patients discharged from hospital under left ventricular assistance.
J Heart Lung Transplant.
2001;
20
53-58
15
Frazier O H, Rose E A, Oz M C, Dembitsky W, McCarthy P, Radovancevic B.
Multicenter clinical evaluation of the HeartMate vented electric left ventricular assist system in patients awaiting heart transplantation.
J Thorac Cardiovasc Surg.
2001;
122
1186-1195
16 Goldstein D J. Thermo cardiosystems ventricular assist devices. In: Goldstein DJ, Oz MC (eds). Cardiac assist devices. Futura Publishing Co, Inc, Armonk, NY 2000; 307 -321
17
Holman W L, Skinner J L, Waites K B, Benza R L, McGiffin M D, Kirklin J K.
Infection during circulatory support with ventricular assist devices.
Ann Thorac Surg.
1999;
68
711-716
18
Holman W L, Davies J E, Rayburn B K, McGiffin D C, Foley B A, Benza R L, Bourge R C, Blood P, Kirklin J K.
Treatment of end-stage heart disease with outpatient ventricular assist devices.
Ann Thorac Surg.
2002;
73
1489-1493
20
John R, Lietz K, Burke E, Ankersmit J, Mancini D, Suciu-Foca N, Edwards N, Rose E, Oz M, Itescu S.
Intravenous immunoglobulin reduces anti-HLA alloreactivity and shortens waiting time to cardiac transplantation in highly sensitized left ventricular assist device recipients.
Circulation.
1999;
100 (Suppl 2)
229-235
21
Koster A, Loebe M, Hansen R, Potapov E V, Noon G PO, Kuppe H, Hetzer R.
Alterations in coagulation after implantation of a pulsatile Novacor LVAD and the axial flow MicroMed DeBakey LVAD.
Ann Thorac Surg.
2000;
70
533-537
22
Long J W.
Advanced mechanical circulatory support with the Heart Mate left ventricular assist device in the year 2000.
Ann Thorac Surg.
2001;
71
176-182
23
Massad M G, Cook D J, Schmitt S K, Smedira N G, McCarthy J F, Vargo R L, McCarthy P M.
Factors influencing HLA sensitation in implantable LVAD recipients.
Ann Thorac Surg.
1997;
64
1120-1125
24
Mehta S M, Pae W E, Rosenberg G, Snyder A J, Weiss W J, Lewis J P. et al .
The LionHeart LVD-2000: a completely implanted left ventricular asasist device for chronic circulatory support.
Ann Thorac Surg.
2001;
71
156-161
26
Ochiai Y, McCarthy P, Smedira N G, Banbury M K, Navia J L, Feng J, Hsu A P, Yeager M L. et al .
Predictors of severe right ventricular failure after implantable left ventricular assist device insertion: analysis of 245 patients.
Circulation.
2002;
106 (Suppl 1)
198-202
27
Oz M C, Goldstein D J, Pepino P, Weinberg A D, Thompson S M, Catanese K, Vargo R L, McCarthy P M, Rose E A, Levin H R.
Screening scale predicts patients successfully receiving long-term implantable left ventricular assist devices.
Circulation.
1995;
92
169-173
28
Oz M C, Argenziano M, Catanese K A, Gardocki M T, Goldstein D J, Ashtom R C, Gelijins A C, Rose E A, Levin H R.
Bridge experience with long-term implantable left ventricular assist devices.
Circulation.
1997;
95
1844-1852
29
Pasque M K, Rogers J G.
Adverse events in the use of HeartMate vented electric and Novacor left ventricular assist devices: Comparing apples and oranges.
J Thorac Cardiovasc Surg.
2002;
124
1063-1067
30
Portner P M, Jansen P GM, Oyer P M, Wheeldon D R, Ramasamy N.
Improved outcomes with an implantable left ventricular assist system: a multicenter study.
Ann Thorac Surg.
2001;
71
205-209
31
Reichenbach S H, Farrar D J, Hill J D.
A versatile intracorporeal ventricular assist device based on the Thoratec VAD system.
Ann Thorac Surg.
2001;
71
171-175
32
Rose E A, Gelijns A C, Moskowitz A J, Heitjan D, Stevenson L W, Dembitsky W, Long J W, Ascheim D D.
Long-term use of a left ventricular assist device for end-stage heart failure.
N Engl J Med.
2001;
345
1435-1443
33
Siegenthaler M P, Martin J, van de Loo A, Doenst T, Bothe W, Beyersdorf F.
Implantation of the permanent Jarvik-2000 left ventricular assist device: a single-center experience.
J Am Coll Cardiol.
2002;
39
1764-1772
