Section of Heart Failure and Cardiac Transplant Medicine, Kaufman Center for Heart Failure Treatment and Recovery, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk J3-4, Cleveland, OH, 44195, USA.
Department of Cardiovascular Surgery, Kaufman Center for Heart Failure Treatment and Recovery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.
ESC Heart Fail. 2019 Jun;6(3):552-554. doi: 10.1002/ehf2.12412. Epub 2019 Apr 9.
Cardiogenic shock from biventricular failure that requires acute mechanical circulatory support carries high 30 day mortality. Acute mechanical circulatory support can serve as bridge to orthotopic heart transplant (OHT) in selected patients. We report a patient with biventricular failure secondary to rapidly progressive cardiac sarcoidosis refractory to medical management who was bridged to OHT with Impella 5.0 and Impella RP-temporary left and right ventricular assist devices, respectively. This is the first successful bridge to transplantation using these devices in biventricular heart failure and cardiogenic shock. We discuss considerations for using this strategy over veno-arterial extracorporeal membrane oxygenation or surgically implanted assist devices in patients with cardiogenic shock and biventricular failure as a bridge to OHT.
因双心室衰竭导致的心源性休克需要急性机械循环支持，其 30 天死亡率很高。急性机械循环支持可作为桥接手段，将合适的患者转运至接受心脏原位移植（OHT）。我们报告了一例因快速进展性心脏结节病导致的双心室衰竭患者，该患者对药物治疗无反应，使用 Impella 5.0 及 Impella RP-临时左、右心室辅助设备进行桥接治疗，分别为左、右心室提供辅助支持，转运至 OHT。这是首例使用这些设备成功桥接治疗双心室心力衰竭和心源性休克的病例。我们讨论了在心源性休克和双心室衰竭患者中，使用这种策略替代静脉-动脉体外膜肺氧合或手术植入辅助设备进行桥接治疗，以转运至 OHT 的注意事项。
