126
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Puehler T, Ensminger S, Schulz U, Fuchs U, Tigges-Limmer K, Börgermann J, Morshuis M, Hakim K, Oldenburg O, Niedermeyer J, Renner A, Gummert J. [Heart and combined heart-lung transplantation. Indications, chances and risks]. Herz 2014; 39:66-73. [PMID: 24452762 DOI: 10.1007/s00059-013-4042-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Orthotopic heart transplantation (HTX) is nowadays the worldwide accepted gold standard for the treatment of terminal heart failure. The main indications for HTX are non-ischemic dilatative (54%) and ischemic (37%) heart failure. In the acute phase after HTX the survival rate is approximately 90%. Good short and long-term results with survival rates ranging from 81% after 1 year to more than 50% after 11 years demonstrate that there is currently no real treatment alternative to HTX for treatment of end-stage heart failure. In the case of irreversible pulmonary hypertension in combination with end-stage heart failure or complex congenital heart syndromes, a combined heart and lung transplantation (HLTX) is necessary. Compared with HTX the short-term survival of HLTX is reduced, mostly for technical reasons. Improved long-term results after HTX and HLTX are a result of highly specialized transplantation units and effective immunosuppression. However, a major problem is the shortage of organ donors in Germany and the resulting long waiting times for patients with frequently occurring blood groups of up to 10 months for transplantation. The consequence of the latter is the ever increasing number of implanted cardiac assist devices in patients not only as a bridge to transplant but also as destination therapy.
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127
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Morshuis M, Schoenbrodt M, Nojiri C, Roefe D, Schulte-Eistrup S, Boergermann J, Gummert JF, Arusoglu L. DuraHeart™ magnetically levitated centrifugal left ventricular assist system for advanced heart failure patients. Expert Rev Med Devices 2014; 7:173-83. [DOI: 10.1586/erd.09.68] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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128
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Salem JE, Paluszkiewicz L, Hulot JS, Perdrix L, Morshuis M, Leprince P, Gummert J, Diebold B, Aissaoui N. Impact of inotropic drugs on the validity of left ventricular filling pressure echocardiographic assessment in end-stage heart failure patients. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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129
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Aissaoui N, Morshuis M, Schoenbrodt M, Hakim Meibodi K, Kizner L, Börgermann J, Gummert J. Temporary right ventricular mechanical circulatory support for the management of right ventricular failure in critically ill patients. J Thorac Cardiovasc Surg 2013; 146:186-91. [DOI: 10.1016/j.jtcvs.2013.01.044] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Revised: 12/20/2012] [Accepted: 01/28/2013] [Indexed: 10/27/2022]
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130
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Paluszkiewicz L, Morshuis M, Gummert J. An echocardiographic presentation of a massive, reverse flow caused by an electrical failure of the left ventricular assist device. The continuous flow device dysfunction. Echocardiography 2013; 30:E251-4. [PMID: 23742189 DOI: 10.1111/echo.12261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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131
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Furukawa N, Morshuis M, Gummert JF. Outflow graft abrasion due to bend relief detachment in a HeartMate II device. Eur J Cardiothorac Surg 2013; 45:394. [PMID: 23696553 DOI: 10.1093/ejcts/ezt274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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132
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Morshuis M, Boergermann J, Gummert J, Koster A. A modified technique for implantation of the HeartWare™ left ventricular assist device when using bivalirudin anticoagulation in patients with acute heparin-induced thrombocytopenia. Interact Cardiovasc Thorac Surg 2013; 17:225-6. [PMID: 23628649 DOI: 10.1093/icvts/ivt187] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
In patients with acute heparin-induced thrombocytopenia (HIT) needing urgent cardiac surgery, bivalirudin is recommended as a first-line strategy for intraoperative anticoagulation. However, due to the unique elimination process of bivalirudin, careful adjustment of the perfusion and surgical strategy is mandatory as blood stasis in the circuit or prolonged interruption of areas or compartments containing blood from the systemic circulation may result in thrombus formation. We report here a modified surgical strategy for the implantation of the HeartWare™ left ventricular assist device, which avoids prolonged disconnection of the blood-filled device from the systemic blood flow, so that bivalirudin can be safely used as anticoagulant.
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133
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Schyma C, Doberentz E, Morshuis M, Madea B. Todesfall eines Patienten mit Herzunterstützungssystem. Rechtsmedizin (Berl) 2013. [DOI: 10.1007/s00194-013-0889-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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134
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Kassner A, Toischer K, Bohms B, Kolkhof P, Abraham G, Hasenfuβ G, Morshuis M, Schulte Eistrup S, El-Banayosy A, Gummert J, Milting H. Regulation of cyclic adenosine monophosphate release by selective β2-adrenergic receptor stimulation in human terminal failing myocardium before and after ventricular assist device support. J Heart Lung Transplant 2013; 31:1127-35. [PMID: 22975104 DOI: 10.1016/j.healun.2012.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Revised: 03/30/2012] [Accepted: 07/18/2012] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Response to catecholamines is blunted in terminal heart failure due to β-receptor downregulation and uncoupling from adenylyl cyclase (AC). Improved myocardial responsiveness to catecholamines after ventricular assist device (VAD) support is associated with upregulation of β1-adrenergic receptors (β1-ARs). Little is known about the regulation of AC and β2-AR coupling after VAD; moreover β2-AR stimulation during VAD was claimed to induce myocardial recovery. METHODS We analyzed in VAD-supported human myocardium the regulation of AC activity upon β1-AR and selective β2-AR stimulation in 8 non-failing hearts (NF) and 17 paired samples of VAD patients. AC messenger RNA was measured by TaqMan. AC was stimulated via β2-AR using clenbuterol (β2-AR agonist) and bisoprolol (β1-AR blocker). Organ bath experiments were done with trabeculae from both ventricles. Samples were stratified according to chronic or acute heart failure history. RESULTS Isoprenaline-induced AC activity was downregulated (p < 0.001) pre-VAD and increased significantly (p < 0.05) after unloading (mean ± standard deviation pmole/mg/min) in NF (47.9 ± 14.9), pre-VAD (24.35 ± 13.3), and post-VAD (50.04 ± 50.25). Forskolin stimulation revealed significant (p < 0.05) upregulation of AC activity during VAD, especially in acutely failing hearts (NF, 192.1 ± 68.7; pre-VAD, 191.1 ± 60.4; post-VAD, 281.5 ± 133). However, forskolin stimulation relative to isoprenaline-induced inotropy remained reduced before and after VAD compared with NF. The selective stimulation of β2-AR did not reveal influence of VAD support on β2-AR-AC coupling. Stimulation of ventricular trabeculae by > 100 μmole/liter clenbuterol revealed negative inotropic responses. CONCLUSIONS VAD does not influence β2-AR coupling to AC stimulation. Elevated response to catecholamines after VAD support is influenced by β1-AR upregulation and modulation of AC activity. Restoration of β-adrenergic responsiveness was restricted to acutely failing hearts.
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135
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Torregrossa G, Gerosa G, Tarzia V, Vida V, Duveau D, Arabia F, Leprince P, Kasirajan V, Beyersdof F, Loforte A, Musumeci F, Hetzer R, Krabatsch T, Gummert J, Morshuis M, Copeland J. Long Term Results with Total Artificial Heart: Is It Prime Time for Destination Therapy? J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.250] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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136
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Schulz U, Morshuis M, Oezpeker C, Hakim-Meibodi K, Ensminger S, Börgermann J, Gummert J. Impact of Different Indications for HU Listing of VAD Patients on Survival after Heart Transplantation. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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137
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Aissaoui N, Paluszkiewicz L, Martin Gorria G, Morshuis M, Diebold B, Joe Elie S, Gummert J. Assessment of Right Ventricle before the Implantation of Left Ventricular Assist Device by Echocardiographic Parameters (ARVADE). J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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138
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Oezpeker C, Oemer S, Schoenbrodt M, Hakim K, Kizner L, Boergermann J, Milting H, Ensminger S, Gummert J, Morshuis M. Prolonged Mechanical Circulatory Support – 1000 Days with a Left Ventricular Assist Device. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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139
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Aissaoui N, Morshuis M, Diebold B, Guerot E, Gummert J. Heart failure while on ventricular assist device support: a true clinical entity? Arch Cardiovasc Dis 2013; 106:44-51. [PMID: 23374971 DOI: 10.1016/j.acvd.2012.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Revised: 09/10/2012] [Accepted: 09/15/2012] [Indexed: 11/16/2022]
Abstract
Ventricular assist devices (VADs) have become an established therapeutic option for patients with end-stage heart failure. The appearance of heart failure in VAD patients seems unexpected. Nevertheless, this phenomenon is not rare. We report six cases of VAD patients with clinical presentation of heart failure at different times after implantation and describe the mechanisms involved. The aetiology of this heart failure, like its clinical presentation, varies and has yet to be identified.
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140
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Morshuis M, Zittermann A, Rössing EV, Gummert JF. INTERMACS level predicts early mortality in patients receiving left ventricular assist device implants. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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141
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Dia M, Zittermann A, Rössing EV, Gummert JF, Morshuis M. Risk factor analysis for survival in CardioWest total artificial heart recipients: A pilot study. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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142
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Paluszkiewicz L, Morshuis M, Koster A, Antonczyk K, Gummert J. A large blood cyst of the mitral valve: late presentation in an 80-year-old female. Eur Heart J Cardiovasc Imaging 2012; 14:315. [PMID: 23034995 DOI: 10.1093/ehjci/jes199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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143
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Furukawa N, Aboud A, Morshuis M, Gummert J. Fulminant fungal infection of a biventricular assist device. J Card Surg 2012; 27:646. [PMID: 22845554 DOI: 10.1111/j.1540-8191.2012.01500.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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144
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Aissaoui N, Morshuis M, Börgermann J, Schönbrodt M, Hakim K, Kizner L, Gummert J. 548 Right Ventricular Failure during Ventricular Assist Device Placement: The Bad Oeynhausen Experience. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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145
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Aissaoui N, Hakim-Meibodi K, Morshuis M, Gummert J. Recurrent thrombosis after mechanical circulatory support. Interact Cardiovasc Thorac Surg 2012; 14:668-9. [PMID: 22350773 DOI: 10.1093/icvts/ivs025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The immediate complication after implantation of mechanical circulatory support (MCS) is more often bleeding than thromboembolic events. We report an unusual case of massive thrombus formation following systemic thrombolytic therapy which happened twice after implantation of MCS. Various mechanisms may contribute to this severe complication, but attention should be paid to patients who receive MCS after systemic thrombolysis because of the secondary hypercoagulability induced by this therapy.
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146
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Brocks Y, Schoenbrodt M, Morshuis M, Gummert J, Tigges-Limmer K. Case report: Neuropsychological therapy for patient with a total artificial heart. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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147
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Aissaoui N, Börgermann J, Morshuis M, Paluszkiewicz L, Kizner L, Gummert JF. Continuous heart ware LVAD thrombosis: Pro-pump change. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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148
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Schima H, Schlöglhofer T, zu Dohna R, Drews T, Morshuis M, Roefe D, Schmitto JD, Strüber M, Wieselthaler G. Usability of ventricular assist systems in daily experience: A multicenter study (VADUSE). Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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149
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Özpeker UC, Al-Khalil R, Erkilet G, Sayin Ö, Morshuis M, Gummert J. Clinical experience with 439 patients with temporary Centrimag VAS – Implantation. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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150
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Aissaoui N, Börgermann J, Gummert J, Morshuis M. HeartWare continuous-flow ventricular assist device thrombosis: the Bad Oeynhausen experience. J Thorac Cardiovasc Surg 2012; 143:e37-9. [PMID: 22245238 DOI: 10.1016/j.jtcvs.2011.12.035] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Accepted: 12/14/2011] [Indexed: 12/01/2022]
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