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Upper-body cannulation for midterm mechanical circulatory support: A novel bridging strategy to cardiac retransplantation
- Source :
- The International Journal of Artificial Organs. 43:743-747
- Publication Year :
- 2020
- Publisher :
- SAGE Publications, 2020.
-
Abstract
- Heart retransplantation remains a controversial issue, due to the overall shortage of donor organs. Many patients put on the waiting list for retransplantation, decompensate rapidly, and do not survive. The use of veno-arterial extracorporeal life support remains an option in such emergency situations as bridge-to-recovery or bridge-to-transplantation therapy. In peripheral femoral configuration, veno-arterial extracorporeal life support improves the patient’s condition by relieving low-cardiac output but immobilizes him or her for an uncertain period of time. The upper-body cannulation is an alternative approach, which allows to maintain the patient awake and mobile. We present two cases of midterm circulatory support as a bridge to heart retransplantation, using upper-body cannulation veno-arterial extracorporeal life support. Two male patients, presenting with progressive cardiac decompensation due to severe graft rejection, were placed on upper-body veno-arterial extracorporeal life support. The stabilization of hemodynamics and improvement of end-organ perfusion could be achieved after extracorporeal life support initiation. After 48 and 40 days, respectively, on extracorporeal life support with active physical therapy and no major adverse events, both patients received a cardiac retransplantation and were eventually discharged home. The presented cases are the first reported where a successful cardiac retransplant was performed following prolonged upper-body extracorporeal life support.
- Subjects :
- medicine.medical_specialty
Bridging (networking)
Graft rejection
Upper body
business.industry
Biomedical Engineering
Medicine (miscellaneous)
Bioengineering
Economic shortage
General Medicine
030204 cardiovascular system & hematology
Surgery
Biomaterials
03 medical and health sciences
0302 clinical medicine
030228 respiratory system
Waiting list
Intravenous Immunoglobulins
Circulatory system
medicine
Bridge to transplantation
business
Subjects
Details
- ISSN :
- 17246040 and 03913988
- Volume :
- 43
- Database :
- OpenAIRE
- Journal :
- The International Journal of Artificial Organs
- Accession number :
- edsair.doi.dedup.....ebc191ade25205090f0d34bc31e7261a