Abstract| Volume 23, ISSUE 10, SUPPLEMENT , S20, October 2017

Extracorporeal Circulatory Support as a Bridge to Decision for Acute Cardiogenic Shock With Impending Organ Failure

      In the unstable patient with impending organ failure, implantation a temporary ventricular assist device (VAD) is associated with a high morbidity and mortality. The use of temporary VADs in acute cardiogenic shock produces a low survival rate. We retrospectively reviewed 46 patients underwent temporary VAD since 2002 at Tohoku University Hospital. Mean age was 39.4. 29 were male (61%). The etiology of heart disease included 41 (87%) patients with primary and secondary cardiomyopathies and 6 (13%) with fulminant myocarditis. 6 patients underwent heart transplantation, 4 weaned from temporary VAD following cardiac recovery, and 10 underwent conversion to durable VAD. In the overall cohort, there were 26 deaths. The patients who died after device implantation were older (P = .002) and supported with BVAD (P = .001). The causes of death were stroke (11), MOF (10), bleeding (3), ARDS (1), and mediastinitis (1). The survival rates were 89%, 72%, 51%, and 47% at 1 month, 3 month, 6 month and 1 year after device implantation. The optimal use of temporary VAD has not been completely elucidated. Alternative strategy is necessary for patients with cardiogenic shock especially biventricular failure.
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