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Veno-arterial Extracorporeal Membrane Oxygenation as Bridge to Heart Transplantation: The Way Forward

Advanced heart failure (HF) represents a public health priority due to the increase of affected patients and the meaningful mortality. Durable mechanical circulatory support (MCS) and heart transplantation (HTx) are unique therapies for end-stage HF (ESHF), with positive early and long-term outcomes...

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Autores principales: Montisci, Andrea, Donatelli, Francesco, Cirri, Silvia, Coscioni, Enrico, Maiello, Ciro, Napoli, Claudio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8270578/
https://www.ncbi.nlm.nih.gov/pubmed/34258387
http://dx.doi.org/10.1097/TXD.0000000000001172
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author Montisci, Andrea
Donatelli, Francesco
Cirri, Silvia
Coscioni, Enrico
Maiello, Ciro
Napoli, Claudio
author_facet Montisci, Andrea
Donatelli, Francesco
Cirri, Silvia
Coscioni, Enrico
Maiello, Ciro
Napoli, Claudio
author_sort Montisci, Andrea
collection PubMed
description Advanced heart failure (HF) represents a public health priority due to the increase of affected patients and the meaningful mortality. Durable mechanical circulatory support (MCS) and heart transplantation (HTx) are unique therapies for end-stage HF (ESHF), with positive early and long-term outcomes. The patients who underwent HTx have a 1-y survival of 91% and a median survival of 12–13 y, whereas the median survival of ESHF is <12 mo. Short-term MCS with veno-arterial extracorporeal membrane oxygenation (VA ECMO) can be used as a bridge to transplantation strategy. Patients bridged with VA ECMO have significantly lower survival in comparison with non-MCS bridged and left ventricular assist device-bridged patients. VA ECMO represents an effective, and sometimes unique, system to obtain rapid hemodynamic stabilization, but possible negative effects on patients’ outcomes after HTx must be considered. Here, we discuss the use of VA ECMO as bridge to transplantation.
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spelling pubmed-82705782021-07-12 Veno-arterial Extracorporeal Membrane Oxygenation as Bridge to Heart Transplantation: The Way Forward Montisci, Andrea Donatelli, Francesco Cirri, Silvia Coscioni, Enrico Maiello, Ciro Napoli, Claudio Transplant Direct Heart Transplantation Advanced heart failure (HF) represents a public health priority due to the increase of affected patients and the meaningful mortality. Durable mechanical circulatory support (MCS) and heart transplantation (HTx) are unique therapies for end-stage HF (ESHF), with positive early and long-term outcomes. The patients who underwent HTx have a 1-y survival of 91% and a median survival of 12–13 y, whereas the median survival of ESHF is <12 mo. Short-term MCS with veno-arterial extracorporeal membrane oxygenation (VA ECMO) can be used as a bridge to transplantation strategy. Patients bridged with VA ECMO have significantly lower survival in comparison with non-MCS bridged and left ventricular assist device-bridged patients. VA ECMO represents an effective, and sometimes unique, system to obtain rapid hemodynamic stabilization, but possible negative effects on patients’ outcomes after HTx must be considered. Here, we discuss the use of VA ECMO as bridge to transplantation. Lippincott Williams & Wilkins 2021-07-08 /pmc/articles/PMC8270578/ /pubmed/34258387 http://dx.doi.org/10.1097/TXD.0000000000001172 Text en Copyright © 2021 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Heart Transplantation
Montisci, Andrea
Donatelli, Francesco
Cirri, Silvia
Coscioni, Enrico
Maiello, Ciro
Napoli, Claudio
Veno-arterial Extracorporeal Membrane Oxygenation as Bridge to Heart Transplantation: The Way Forward
title Veno-arterial Extracorporeal Membrane Oxygenation as Bridge to Heart Transplantation: The Way Forward
title_full Veno-arterial Extracorporeal Membrane Oxygenation as Bridge to Heart Transplantation: The Way Forward
title_fullStr Veno-arterial Extracorporeal Membrane Oxygenation as Bridge to Heart Transplantation: The Way Forward
title_full_unstemmed Veno-arterial Extracorporeal Membrane Oxygenation as Bridge to Heart Transplantation: The Way Forward
title_short Veno-arterial Extracorporeal Membrane Oxygenation as Bridge to Heart Transplantation: The Way Forward
title_sort veno-arterial extracorporeal membrane oxygenation as bridge to heart transplantation: the way forward
topic Heart Transplantation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8270578/
https://www.ncbi.nlm.nih.gov/pubmed/34258387
http://dx.doi.org/10.1097/TXD.0000000000001172
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