How to demonstrate the reversibility of end-organ function before implantation of left ventricular assist device in INTERMACS profile 2 patients?
For the time being, in Japan, two recently approved implantable ventricular assist devices (VADs) are indicated only when a patient has been listed for heart transplantation or approved to be eligible for heart transplantation by in-hospital committee. The reversibility of end-organ dysfunction must be expected before VAD implantation, but it is often hard to prove during worsening clinical status. We report two patients whose end-organ dysfunction had been eventually demonstrated to be reversible by invasive procedures such as transluminal liver biopsy or transient insertion of intra-aortic balloon pumping.
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. imamurate-int@h.u-tokyo.ac.jp
Teruhiko
T
Imamura
Koichiro
K
Kinugawa
Taro
T
Shiga
Naoko
N
Kato
Miyoko
M
Endo
Toshiro
T
Inaba
Hisataka
H
Maki
Masaru
M
Hatano
Atsushi
A
Yao
Yasunobu
Y
Hirata
Masaaki
M
Akahane
Takashi
T
Nishimura
Shunei
S
Kyo
Minoru
M
Ono
Ryozo
R
Nagai
D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D004867:Equipment Design; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006505:Hepatitis / Q000150:complications; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D063305:Organ Dysfunction Scores; D018579:Patient Selection; D051437:Renal Insufficiency / Q000150:complications; D016896:Treatment Outcome