Cardiac transplant or rotary blood pump: Contemporary evidence

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Presentation transcript:

Cardiac transplant or rotary blood pump: Contemporary evidence Stephen Westaby, MS, PhD, FRCS, FECTS, FESC, FACC The Journal of Thoracic and Cardiovascular Surgery Volume 145, Issue 1, Pages 24-31 (January 2013) DOI: 10.1016/j.jtcvs.2012.08.048 Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Myocardial regeneration therapy. Plain radiograph of a patient with ischemic cardiomyopathy with cardiac resynchronization and an implantable defibrillator who was inotrope dependent in the hospital for 3 months. He received a Jarvik FlowMaker device with a skull pedestal power delivery plus intramyocardial injection of autologous bone marrow stem cells. Twelve months later he was in New York Heart Association class I with objective evidence of improved myocardial perfusion and contractility. (From Anastasiadis K, Antonitsis P, Doumas K, Koliakos G, Argiriadou H, Vaitsopolou C, et al. Stem cells transplantation combined with long-term mechanical circulatory support enhances myocardial viability in end-stage ischemic cardiomyopathy. Int J Cardiol. 2012;155:e51-3. Reprinted with permission from Elsevier.) The Journal of Thoracic and Cardiovascular Surgery 2013 145, 24-31DOI: (10.1016/j.jtcvs.2012.08.048) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 General comparative analysis of outcomes of patients listed for heart transplantation as status 1A, 1B, and 2, patients undergoing orthotopic heart transplantation, and patients in the placebo groups reported by major clinical trials. OPTN, Organ Procurement and Transplantation Network; UNOS, United Network for Organ Sharing; ISHLT, International Society for Heart and Lung Transplantation; REMATCH, Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure; ESSENTIAL, Studies of Oral Enoximone Therapy in Advanced Heart Failure (Trial); COPERNICUS, Carvedilol Prospective Randomized Cumulative Survival (Study Group); CONSENSUS; MERIT HF; MIRACLE; US Carvedilol; CIBIS; RALES; VEHEFT; BEST; MADIT; DEFINITE; SOLVD Rx; SCD CHF. (From Cadeiras M, Von Beyern MP, Deng MC. Cardiac transplantation. Any role left? Heart Fail Clin. 2007;3:321-48. Reprinted with permission from Elsevier.) The Journal of Thoracic and Cardiovascular Surgery 2013 145, 24-31DOI: (10.1016/j.jtcvs.2012.08.048) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 General comparative analysis of outcomes patients listed for heart transplantation as status 1A, 1B, and 2, patients undergoing orthotopic heart transplantation, mechanical circulatory support device implantation, and patients in the treatment groups reported by major clinical trials. For acronyms, see legend to Figure 2. (From Cadeiras M, Von Beyern MP, Deng MC. Cardiac transplantation. Any role left? Heart Fail Clin. 2007;3:321-48. Reprinted with permission from Elsevier.) The Journal of Thoracic and Cardiovascular Surgery 2013 145, 24-31DOI: (10.1016/j.jtcvs.2012.08.048) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions