Upload
others
View
2
Download
0
Embed Size (px)
Citation preview
The Mechanical Heart - The future of surgery for Adult CHD ?
Ivan M. Rebeyka University of Alberta
& Stollery Children’s
Hospitals
ACHD Patient Day May 23, 2015
Number of Heart Transplants Reported by Year
189 318669
1185
21652720
3156 3380
4024 4186 4219 4382 4438 4356 4206 40873769
3436 3314 3219 3107
0
500
1000
1500
2000
2500
3000
3500
4000
4500
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
Num
ber
of T
rans
plan
ts
Ref.: ISHLT, J Heart and Lung Transplant 2004; 23: 796-803
Current Ventricular Assist Device (VAD) Options
o Berlin Heart
o HeartWare (HVAD)
o Heartmate II
o Total Artificial heart (Syncardia)
0
50
100
150
200
250
Feb.1990
Mai.199
1
Jul.1
992
Dez.19
92
Jul.1
993
Apr.19
95
Mai.199
6
Aug.19
97
Mai.199
8
Sep.19
98
Nov.19
99
Mai.200
0
Nov.20
00
Jun.2
001
Mrz.200
2
Jan.2
003
Okt.20
03
Apr.20
04
Aug.20
04
Nov.20
04
Feb.2005
Mai.200
5
Aug.20
05
Nov.20
05
Feb.2006
Mai.200
6
Aug.20
06
Patients
Total Impl.US/Canada
August 2004
Total World-wide Pediatric Berlin Heart Implants
August, 2004
HeartWare - II
o Flow - 3.5-7.0 L/min (max 10 L/min)
o Long-term device n Longest current implant – 7 years !!!
Minimally invasive implant II
o Superior Hemisternotomy + 5th ICS thoracotomy
o Aortic arterial / femoral venous cannulae
o ? Off-pump – Germany / Austria
What do we do after the mechanical heart is in ?
• Transplantation
• Recovery (Bridge To Recovery)
• Withdrawal of therapy
• ........
What do we do after the mechanical heart is in ?
• Transplantation
• Recovery (Bridge To Recovery)
• Withdrawal of therapy
• Implantable VAD (Destination therapy)