초록접수 현황
| 17F-258 | 구연 발표 |
Early Experience of Durable Left Ventricular Assist Devices: Do we Need Bridge-to-transplant Strategy in Korea?
Jun Ho Lee, Yang Hyun Cho, Dong Seop Jeong, Ji-Hyuk Yang, Kiick Sung, Wook Sung Kim, Tae-Gook Jun, Young Tak Lee, Pyo Won Park
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Purpose : Although a durable left ventricular assist device (LVAD) is widely used as both bridge to transplant (BTT) and destination strategies in other countries , there is no Korean data on LVAD.
Methods : From August 2012 to July 2017, 15 patients (5 females; mean age = 68 ± 12 years) received the HeartMate II (HMII; n = 4) or the HVAD (n = 11). There were 10 destination therapy (DT) patients and 5 bridge to candidacy (BTC) patients.
Results : All patients had modifiable (BTC group) or unmodifiable absolute (DT group) contraindications of transplantation. The diagnosis was ischemic cardiomyopathy in 8, and dilated cardiomyopathy in 7. Four patients (4/5, 80%) in the BTC group had extracorporeal membrane oxygenation (ECMO) or temporary LVAD, preoperatively. The average duration of LVAD support were 410.8 ± 258.5 days (range: 144 - 785) in the BTC group and 552.0 ± 627.4 days (range: 40 – 1811) in the DT group. There was no 30-day mortality in both groups. One patient in DT group underwent transplantation (after 1.9 years) because of device malfunction.
Conclusion : Two thirds of our patients had LVAD as DT. Although there was no definite BTT patient, some patients had modifiable contraindications of transplantation. Considering excellent short and middle term outcome, LVAD as BTT or BTC may improve both mortality on waiting list and transplant mortality.
Methods : From August 2012 to July 2017, 15 patients (5 females; mean age = 68 ± 12 years) received the HeartMate II (HMII; n = 4) or the HVAD (n = 11). There were 10 destination therapy (DT) patients and 5 bridge to candidacy (BTC) patients.
Results : All patients had modifiable (BTC group) or unmodifiable absolute (DT group) contraindications of transplantation. The diagnosis was ischemic cardiomyopathy in 8, and dilated cardiomyopathy in 7. Four patients (4/5, 80%) in the BTC group had extracorporeal membrane oxygenation (ECMO) or temporary LVAD, preoperatively. The average duration of LVAD support were 410.8 ± 258.5 days (range: 144 - 785) in the BTC group and 552.0 ± 627.4 days (range: 40 – 1811) in the DT group. There was no 30-day mortality in both groups. One patient in DT group underwent transplantation (after 1.9 years) because of device malfunction.
Conclusion : Two thirds of our patients had LVAD as DT. Although there was no definite BTT patient, some patients had modifiable contraindications of transplantation. Considering excellent short and middle term outcome, LVAD as BTT or BTC may improve both mortality on waiting list and transplant mortality.
첨부파일 : Figure and Table.pdf
책임저자: Yang Hyun Cho
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
발표자: Jun Ho Lee, E-mail : ps-gamer@hanmail.net