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Mechanical Circulatory Support in End-Stage Heart Failure Mechanical Circulatory Support in End-Stage Heart Failure Andrea Montalto Antonio Loforte Francesco Musumeci Thomas Krabatsch Mark S. Slaughter Editors Mechanical Circulatory Support in End-Stage Heart Failure A Practical Manual In collaboration with Cristiano Amarelli Editors Andrea Montalto Thomas Krabatsch San Camillo-Forlanini Hospital Deutsches Herzzentrum Berlin Rome, Italy Berlin, Germany Antonio Loforte Mark S. Slaughter Cardiac Surgery Department of Cardiovascular S.Orsola-Malpighi Hospital and Thoracic Surgery Bologna, Italy University of Louisville Louisville, KY, USA Francesco Musumeci San Camillo-Forlanini Hospital Rome, Italy ISBN 978-3-319-43381-3 ISBN 978-3-319-43383-7 (eBook) DOI 10.1007/978-3-319-43383-7 Library of Congress Control Number: 2017943505 © Springer International Publishing Switzerland 2017 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Printed on acid-free paper This Springer imprint is published by Springer Nature The registered company is Springer International Publishing AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland V To all patients whose desire for a better life inspired me Andrea Montalto To my beloved daughter, Alessandra, and wife, Elisa Antonio Loforte To my relatives and friends who cared and loved me, supporting my curiosity and perseverance after the loss of my father Cristiano Amarelli VII Preface »» We are all God’s knights and knights of have an elevated risk of mortality post- life. operatively while patients with an early This is my destiny, this is the message heart dysfunction scenario may have a that God tells me to bring. poor benefit, thus being more exposed to A message of life and hope for me and device-related complications. Preopera- for others. tive hemodynamic and clinical scenarios Whatever happens do not close my which may occur are extremely different sufferings in a drawer or a sad from those the clinicians routinely have thought. to face up to with traditional cardiac sur- I was always smiling. Remember my gery therapy. Proper management and smile and my will to live. interpretation of MCS-related compli- Go ahead and tell it so that it can be of cations is an additional concern to deal relief and hope for others. with particularly in the case of non-hub It should be a happy memory. and well-trained centers. Moreover, the So in the worst case a knight will psychological aspects and views of long- become an angel. term VAD/TAH recipients which may Mario C. influence the overall outcome should not be underestimated. End-stage acute and chronic heart failure refractory to maximal pharmacolog­ical The complexity of MCS therapy and its therapy carries a poor chance of survival clinical landscape, as well as the devotion for patients unless they undergo heart of free minds in discovering, always case transplantation. Heart transplantation by case, the adequate treatment of such a is restricted by age and comorbidities to delicate patient population, stimulated all a small group of patients, and the actual of us to develop such an ambitious proj- donor’s shortage does not meet properly ect. We aimed at building a textbook that the demand of patients on waiting list. would be a practical guide in terms of Mechanical circulatory support is a valid correct and well-accepted management temporary solution before heart trans- of patients undergoing implantation of plantation, whose results are playing the VAD and TAH. Our goal was to move up role of a game-changer in such a challeng- from a pioneer’s phase of MCS adopted in ing field. The choice and management of few centers in the world to a world-wide the right device for every patient remains standardized and shared management of a tricky. Giving the equipoise of the short such effective therapy. In order to accom- and even the midterm results between plish all of the above, we approached all LVADs and heart transplantation expe- those renowned centers and physicians rienced in the last decade, the use as worldwide who, over the years, have spent destination therapy is gaining space, per- interest and time mostly in studying deeply mitting to promptly treat a wider patient such a delicate medicine field which is population. Prompt availability and heart failure mechanical treatment. We cost-effectiveness as unique constraint encouraged all authors to enrich their con- are the mainstreams of the mechanical tributions with tables and algorithms in solution. The proper selection of can- order to render each chapters adoptable didates for VAD or TAH implantation as a guiding protocol, thus providing keys remains a challenging clinical decision. for the resolution of any kind of tradition- Patients who are too compromised may ally discussed issue. Our goal has been VIII Preface welcomed with great enthusiasm by all have devoted their time to the realization authors who have fully grasped the essence of this book which we hope will be a valu- of this project. It is therefore with great able tool to improve survival and quality of satisfaction that we thank all those who, life of those people who are living thanks despite the onerous work commitments, to an artificial heart support system. Andrea Montalto Rome, Italy Antonio Loforte Bologna, Italy Francesco Musumeci Rome, Italy Thomas Krabatsch Berlin, Germany Mark S. Slaughter Louisville, USA IX Contents 1 Invited Lecture “Pioneering the Future: From Transplant to Device Development”........................................................................................................... 1 O.H. Frazier I Preoperative Evaluation 2 Physiopathology and Fate of End-Stage CHF in the Era of MCS..................... 13 Vito Piazza, A. Montalto, C. Amarelli, A. Loforte, and Francesco Musumeci 3 Cardiomyopathies and Clinical Features........................................................................ 25 F. Grigioni, L. Potena, G. Marinelli, and Marco Masetti 4 MCS Candidate Selection Criteria....................................................................................... 37 Cristiano Amarelli, Marianna Buonocore, Ciro Maiello, Andrea Montalto, and Georg Wieselthaler 5 Preoperative Assessment and Clinical Optimization............................................. 59 Maria Frigerio, Manlio Cipriani, Fabrizio Oliva, and Federico Pappalardo 6 Preoperative Evaluation of Right Ventricular Function....................................... 75 Michael Dandel, Evgenij V. Potapov, and Nader Moazami 7 High INTERMACS Profiles: Medical Versus MCS Treatment................................ 93 A. Barbone and Bart P. Meyns 8 Low INTERMACS Profiles: Temporary ECMO or TAH Support........................... 103 V. Tarzia, G. Bortolussi, Lorenzo Bagozzi, T. Bottio, and G. Gerosa 9 Low INTERMACS Profiles: Temporary Midterm Paracorporeal VAD Support...................................................................................................................................... 107 Steven Tsui, Colleen Pietras, and David L. Joyce 10 Low INTERMACS Profiles: One-Stage Durable LVAD Implantation for INTERMACS Level 1: Indications and Contraindications.............................. 115 Daisuke Yoshioka, Koji Takeda, Hiroo Takayama, and Yoshifumi Naka 11 Bridge to Transplant and Destination Therapy Strategies in the United States...................................................................................................................... 121 Yasuhiro Shudo, Hanjay Wang, Andrew B. Goldstone, and Y. Joseph Woo 12 Mechanical Circulatory Support as Bridge to Recovery....................................... 131 Michael Dandel and Stephan Schueler 13 Mechanical Circulatory Support as Bridge to Candidacy.................................... 149 Maria Frigerio, Manlio Cipriani, and David Feldman X Contents II Intraoperative Tips and Pitfalls 14 Engineering and Clinical Considerations in Rotary Blood Pumps................ 163 F. Moscato and H. Schima 15 Engineering and Clinical Considerations in Pulsatile Blood Pump.............. 175 Oliver Voigt and Friedrich Kaufmann 16 Intraoperative Anesthesiological Monitoring and Management.................. 183 M. Baiocchi, M. Benedetto, and G. Frascaroli 17 Transesophageal Echocardiography During LVAD Implantation.................. 193 Marian Kukucka 18 Intraoperative Anticoagulation and Coagulation Management.................... 201 Andreas Koster and Federico Pappalardo
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