[Mechanical myocardial support systems 1997: an overview of inta-aortic balloon counterpulsation to implantable left ventricular support systems].
The development of cardiopulmonary bypass (CPB) to support the systemic circulation during cardiac surgical procedures became a clinical reality in 1953. Although the use of CPB for the treatment of post-infarction cardiogenic shock met with little success, intra-aortic balloon counterpulsation was used successfully in 1968 to reduce ischaemic injury in a patient with cardiogenic shock. Today, a broad spectrum of circulatory assist devices for short- and long-term application is available. Three major indication groups for the use of support devices are established. In low-cardiac-output syndrome after cardiac surgical procedures, short-term devices are utilised to enable myocardial recovery. In transplantation candidates suffering from drug-resistant pump failure, the implantation of long-term devices as a bridge to heart transplantation is indicated, and in NYHA class IV patients with contraindications to heart transplantation, the implantation of long-term devices as an alternative to transplantation is under discussion. In the literature, post-cardiotomy support survival is less than 30% on average. About 70% of mechanically bridged patients have survived to undergo heart transplantation and were transplanted with over 90% survival. Major problems during mechanical support are infection, bleeding, and thromboembolism. In view of patients' natural course without support, these clinical results are favourable.
Hammel
D
D
Klinik und Poliklinik für Thorax-, Herz- und Gefässchirurgie, Westfälische Wilhelms Universität Münster.
Möllhoff
T
T
Soepawata
R
R
van Aken
H
H
Scheld
H H
HH
D017147:Defibrillators, Implantable / Q000009:adverse effects; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000009:adverse effects; D008021:Life Support Systems; D018487:Ventricular Dysfunction, Left / Q000628:therapy*
Mechanische myokardiale Unterstützungssysteme 1997. Eine Ubersicht von der intraaortalen Ballongegenpulsation bis zu den implantierbaren linksventrikulären Unterstützungssystemen.