title: [Benefit of paracorporeal pulsatile assist device in multiorgan failing patients in terminal stage of heart failure].
abstract: BACKGROUND
  Prevalence of terminal forms of heart failure is steadily increasing and thus waiting time for heart transplantation, too. Increasing mortality on waiting list has urged implementation of mechanical circulatory support as an adjunct to the programme of heart transplantation. The objective of the study is to review 7-years experience with paracorporeal assist device in bridging to transplantation.
  
  
  METHODS
  Retrospective review of 53 transplant candidates treated since April 2003. 50 patients received paracorporeal assist devices in biventricular configuration. Most frequent diagnosis was dilated cardiomyopathy in 51%.
  
  
  RESULTS
  Despite a high risk profile of the patients, 37 of them were successfully transplanted (69.8%). Cumulative support has reached 3513 days. Local exit sites infection was identified as a most frequent complication, sepsis as a most frequent cause of death on support (18.8%). 30-days post-transplant mortality remained low at 5.7%.
  
  
  CONCLUSIONS
  Paracorporeal mechanical circulatory assist devices remain effective alternative for terminal stage heart transplant candidates, especially for those in multiorgan failure who require biventricular support. Success rate of bridging to transplantation is acceptable, as well as complications rate and quality of life while on support. Long-term post-transplant survival is not inferior to the results of procedures performed without necessity of previous implantation of the assist device.
authors.affiliation: Institut klinické a experimentální medicíny Praha, Klinika kardiovaskulární chirurgie. ivan.netuka@ikem.cz
authors.forename: Ivan
authors.initials: I
authors.lastname: Netuka
authors.forename: Jirí
authors.initials: J
authors.lastname: Malý
authors.forename: Hynek
authors.initials: H
authors.lastname: Ríha
authors.forename: Ondrej
authors.initials: O
authors.lastname: Szarszoi
authors.forename: Zora
authors.initials: Z
authors.lastname: Dorazilová
authors.forename: Ivo
authors.initials: I
authors.lastname: Skalsky
authors.forename: Daniel
authors.initials: D
authors.lastname: Turek
authors.forename: Marian
authors.initials: M
authors.lastname: Urban
authors.forename: Jirí
authors.initials: J
authors.lastname: Kettner
authors.forename: Jan
authors.initials: J
authors.lastname: Pirk
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D016027:Heart Transplantation; D006353:Heart-Assist Devices / Q000009:adverse effects; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000150:complications / Q000628:therapy*; D055815:Young Adult