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2019 EACTS Expert Consensus on long-term mechanical circulatory support
EV. Potapov, C. Antonides, MG. Crespo-Leiro, A. Combes, G. Färber, MM. Hannan, M. Kukucka, N. de Jonge, A. Loforte, LH. Lund, P. Mohacsi, M. Morshuis, I. Netuka, M. Özbaran, F. Pappalardo, AM. Scandroglio, M. Schweiger, S. Tsui, D. Zimpfer, F. Gustafsson,
Language English Country Germany
Document type Consensus Development Conference, Journal Article
NLK
Free Medical Journals
from 1987
Medline Complete (EBSCOhost)
from 2012-11-01 to 1 year ago
PubMed
31100109
DOI
10.1093/ejcts/ezz098
Knihovny.cz E-resources
- MeSH
- Prosthesis Implantation instrumentation methods MeSH
- Cardiac Surgical Procedures instrumentation methods MeSH
- Humans MeSH
- Perioperative Care methods MeSH
- Heart-Assist Devices * MeSH
- Postoperative Complications diagnosis therapy MeSH
- Heart Failure complications diagnosis surgery MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Consensus Development Conference MeSH
Long-term mechanical circulatory support (LT-MCS) is an important treatment modality for patients with severe heart failure. Different devices are available, and many-sometimes contradictory-observations regarding patient selection, surgical techniques, perioperative management and follow-up have been published. With the growing expertise in this field, the European Association for Cardio-Thoracic Surgery (EACTS) recognized a need for a structured multidisciplinary consensus about the approach to patients with LT-MCS. However, the evidence published so far is insufficient to allow for generation of meaningful guidelines complying with EACTS requirements. Instead, the EACTS presents an expert opinion in the LT-MCS field. This expert opinion addresses patient evaluation and preoperative optimization as well as management of cardiac and non-cardiac comorbidities. Further, extensive operative implantation techniques are summarized and evaluated by leading experts, depending on both patient characteristics and device selection. The faculty recognized that postoperative management is multidisciplinary and includes aspects of intensive care unit stay, rehabilitation, ambulatory care, myocardial recovery and end-of-life care and mirrored this fact in this paper. Additionally, the opinions of experts on diagnosis and management of adverse events including bleeding, cerebrovascular accidents and device malfunction are presented. In this expert consensus, the evidence for the complete management from patient selection to end-of-life care is carefully reviewed with the aim of guiding clinicians in optimizing management of patients considered for or supported by an LT-MCS device.
Complexo Hospitalario Universitario A Coruña CIBERCV UDC La Coruña Spain
Department of Anaesthesiology German Heart Center Berlin Berlin Germany
Department of Anesthesia and Intensive Care San Raffaele Hospital Vita Salute University Milan Italy
Department of Cardiology Rigshospitalet Copenhagen Denmark
Department of Cardiology University Medical Center Utrecht Utrecht Netherlands
Department of Cardiothoracic and Vascular Surgery German Heart Center Berlin Germany
Department of Cardiothoracic Surgery Erasmus University Medical Center Rotterdam Netherlands
Department of Cardiovascular Surgery Ege University Izmir Turkey
Department of Congenital Pediatric Surgery Zurich Children's Hospital Zurich Switzerland
Department of Medical Microbiology University College of Dublin Dublin Ireland
Department of Surgery Division of Cardiac Surgery Medical University of Vienna Vienna Austria
DZHK Partner Site Berlin Germany
Institute for Clinical and Experimental Medicine Prague Czech Republic
References provided by Crossref.org
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- $a Long-term mechanical circulatory support (LT-MCS) is an important treatment modality for patients with severe heart failure. Different devices are available, and many-sometimes contradictory-observations regarding patient selection, surgical techniques, perioperative management and follow-up have been published. With the growing expertise in this field, the European Association for Cardio-Thoracic Surgery (EACTS) recognized a need for a structured multidisciplinary consensus about the approach to patients with LT-MCS. However, the evidence published so far is insufficient to allow for generation of meaningful guidelines complying with EACTS requirements. Instead, the EACTS presents an expert opinion in the LT-MCS field. This expert opinion addresses patient evaluation and preoperative optimization as well as management of cardiac and non-cardiac comorbidities. Further, extensive operative implantation techniques are summarized and evaluated by leading experts, depending on both patient characteristics and device selection. The faculty recognized that postoperative management is multidisciplinary and includes aspects of intensive care unit stay, rehabilitation, ambulatory care, myocardial recovery and end-of-life care and mirrored this fact in this paper. Additionally, the opinions of experts on diagnosis and management of adverse events including bleeding, cerebrovascular accidents and device malfunction are presented. In this expert consensus, the evidence for the complete management from patient selection to end-of-life care is carefully reviewed with the aim of guiding clinicians in optimizing management of patients considered for or supported by an LT-MCS device.
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