Severe heart failure and the need for mechanical circulatory support and heart transplantation in pediatric patients with myocarditis: Results from the prospective multicenter registry “MYKKE”

2019 ◽  
Vol 23 (7) ◽  
Author(s):  
Stephan Schubert ◽  
Bernd Opgen‐Rhein ◽  
Martin Boehne ◽  
Annika Weigelt ◽  
Robert Wagner ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Transplantation ◽  
Mechanical Circulatory Support ◽  
Pediatric Patients ◽  
Severe Heart Failure ◽  
Circulatory Support ◽  
Multicenter Registry

scholarly journals Pediatric Palliative Care in the Heart Failure, Ventricular Assist Device and Transplant Populations: Supporting Patients, Families and Their Clinical Teams

Children ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. 468
Author(s):  
Kyle D. Hope ◽  
Priya N. Bhat ◽  
William J. Dreyer ◽  
Barbara A. Elias ◽  
Jaime L. Jump ◽  
...  
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Heart Transplantation ◽  
Ventricular Assist Device ◽  
Mechanical Circulatory Support ◽  
Pediatric Palliative Care ◽  
Circulatory Support ◽  
Assist Device ◽  
Ventricular Assist ◽  
Patients With Heart Failure

Heart failure is a life-changing diagnosis for a child and their family. Pediatric patients with heart failure experience significant morbidity and frequent hospitalizations, and many require advanced therapies such as mechanical circulatory support and/or heart transplantation. Pediatric palliative care is an integral resource for the care of patients with heart failure along its continuum. This includes support during the grief of a new diagnosis in a child critically ill with decompensated heart failure, discussion of goals of care and the complexities of mechanical circulatory support, the pensive wait for heart transplantation, and symptom management and psychosocial support throughout the journey. In this article, we discuss the scope of pediatric palliative care in the realm of pediatric heart failure, ventricular assist device (VAD) support, and heart transplantation. We review the limited, albeit growing, literature in this field, with an added focus on difficult conversation and decision support surrounding re-transplantation, HF in young adults with congenital heart disease, the possibility of destination therapy VAD, and the grimmest decision of VAD de-activation.

Surgical methods of treatment of chronic heart failure and their place in modern clinical recommendations

2020 ◽  
Vol 22 (4) ◽  
pp. 183-191
Author(s):  
O. T. Kotsoeva ◽  
A. V. Koltsov ◽  
V. V. Tyrenko ◽  
A. A. Ialovets
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Left Ventricle ◽  
Heart Transplantation ◽  
Mechanical Circulatory Support ◽  
Circulatory Support ◽  
Surgical Methods ◽  
The Moment

This review discusses a number of aspects of surgical methods for treating severe chronic heart failure: resynchronizing therapy, mechanical circulatory support systems, and heart transplantation. Surgical methods for the treatment of heart failure are a rapidly developing field of modern cardiology and cardiac surgery. The main surgical method of treatment was and remains orthotopic transplantation of a donor heart. The advent of implantable systems has affected the problem of heart transplantation. Over the past decade, the use of mechanical circulatory support systems has grown significantly. At the moment, there are 3 main directions: creating devices for auxiliary blood circulation, various modes and methods of electrical stimulation of the myocardium, creating devices that mechanically remodel the heart chambers (left ventricle). All of these directions to some extent (depending on the evidence base) have found their place in modern recommendations for the treatment of chronic heart failure. The use of mechanical left ventricular remodeling shows good results in patients suffering from symptomatic heart failure, which leads to a significant and persistent decrease in the volume of the left ventricle and improvement of its function, symptoms and quality of life. Despite the fact that at the moment the geography and prevalence of their use is small, the number of implanted devices will only grow. Thus, given the need for frequent hospitalizations and high treatment costs, it is necessary to improve modern methods of surgical treatment of severe and terminal heart failure, make them more accessible, which will affect the duration and quality of life of these patients.

scholarly journals Value of SERCA2a as a Biomarker for the Identification of Patients with Heart Failure Requiring Circulatory Support

2021 ◽  
Vol 11 (11) ◽  
pp. 1122
Author(s):  
Meryem Ezzitouny ◽  
Esther Roselló-Lletí ◽  
Manuel Portolés ◽  
Ignacio Sánchez-Lázaro ◽  
Miguel Ángel Arnau-Vives ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sarcoplasmic Reticulum ◽  
Heart Transplantation ◽  
Predictive Value ◽  
Mechanical Circulatory Support ◽  
Circulatory Support ◽  
Bridge To Recovery ◽  
Blood Samples ◽  
Cytoplasmic Transport ◽  
Patients With Heart Failure

Background: Heart failure (HF) alters the nucleo-cytoplasmic transport of cardiomyocytes and reduces SERCA2a levels, essential for intracellular calcium homeostasis. We consider in this study whether the molecules involved in these processes can differentiate those patients with advanced HF and the need for mechanical circulatory support (MCS) as a bridge to recovery or urgent heart transplantation from those who are clinically stable and who are transplanted in an elective code. Material and method: Blood samples from 29 patients with advanced HF were analysed by ELISA, and the plasma levels of Importin5, Nucleoporin153 kDa, RanGTPase-Activating Protein 1 and sarcoplasmic reticulum Ca2+ ATPase were compared between patients requiring MCS and those patients without a MCS need prior to heart transplantation. Results: SERCA2a showed significantly lower levels in patients who had MCS compared to those who did not require it (0.501 ± 0.530 ng/mL vs. 1.123 ± 0.661 ng/mL; p = 0.01). A SERCA2a cut-off point of 0.84 ng/mL (AUC 0.812 ± 0.085, 95% CI: 0.646–0.979; p = 0.004) provided a 92% sensitivity, 62% specificity, 91% negative predictive value and 67% positive predictive value. Conclusions: In this cohort, patients with advanced HF and a need for MCS have shown significantly lower levels of SERCA2a as compared to stable patients without a need for MCS prior to heart transplantation. This is a small study with preliminary findings, and larger-powered dedicated studies are required to confirm and validate these results.

Mechanical Circulatory Support for Severe Heart Failure After Operation

1998 ◽  
Vol 22 (1) ◽  
pp. 82-84 ◽  
Author(s):  
Hitoshi Koyanagi ◽  
Masaya Kitamura ◽  
Shigeyuki Aomi ◽  
Mitsuhiro Hachida ◽  
Hiroshi Nishida ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mechanical Circulatory Support ◽  
Severe Heart Failure ◽  
Circulatory Support

Alterations in MicroRNAs Are Associated with Myocardial Recovery in Severe Heart Failure Patients on Mechanical Circulatory Support

2008 ◽  
Vol 14 (6) ◽  
pp. S45
Author(s):  
Ravi Ramani ◽  
Bonnie Lemster ◽  
Vishnupriya Samarendra ◽  
Dennis McNamara ◽  
Robert Kormos ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mechanical Circulatory Support ◽  
Severe Heart Failure ◽  
Circulatory Support ◽  
Myocardial Recovery ◽  
Heart Failure Patients

Current Strategy for Severe Heart Failure with Mechanical Circulatory Support

1995 ◽  
Vol 19 (7) ◽  
pp. 766-768 ◽  
Author(s):  
Hitoshi Koyanagi ◽  
Masaya Kitamura ◽  
Hiroshi Nishida ◽  
Mitsuhiro Hachida ◽  
Masahiro Endo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mechanical Circulatory Support ◽  
Severe Heart Failure ◽  
Circulatory Support ◽  
Current Strategy

scholarly journals Mechanical Circulatory Support in Advanced Heart Failure

2021 ◽  
pp. 263246362110327
Author(s):  
Sonali Arora ◽  
Auras R. Atreya
Keyword(s):  
Heart Failure ◽  
Cardiogenic Shock ◽  
Heart Transplantation ◽  
Medical Therapy ◽  
Mechanical Circulatory Support ◽  
Advanced Heart Failure ◽  
Ventricular Assist Devices ◽  
Circulatory Support ◽  
Ventricular Assist ◽  
Advanced Therapies

Advanced heart failure (HF) with persistent and progressive clinical decline despite maximal medical therapy portends a high mortality in the absence of advanced therapies, such as ventricular assist devices or heart transplantation. A subset of these advanced HF patients deteriorates into refractory cardiogenic shock, that is challenging to manage with vasoactive agents alone. Temporary mechanical circulatory support (MCS) device options have evolved over the years and provide a viable option to rescue and rest the myocardium of patients in cardiogenic shock. The goal of such therapy is to serve as bridge to recovery, or more often, a bridge to durable advanced therapies. For those patients with progressive advanced HF despite extensive medical therapy, durable MCS devices (ventricular assist devices) are available when heart transplantation is not feasible. In this article, we review currently available temporary and durable MCS devices, with a focus on their hemodynamic profiles, to inform optimal device selection for patients with advanced HF.

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