tailieunhanh - Ebook Drug and device selection in heart failure: Part 2

(BQ) Part 2 book "Drug and device selection in heart failure" presents the following contents: Percutaneous mechanical support, cardiac resynchronization therapy, atrial arrhythmias in heart failure, heart transplantation, heart failure, ventricular tachyarrhythmias in patients with congestive heart failure,. | CHAPTER Percutaneous Mechanical Support 8 Raphael E Bonita Kariann Abbate INTRODUCTION There are approximately million people in the United States living with heart failure HF .1 These numbers are expected to increase over the next decade due to the aging population. Despite the increasing prevalence of HF the number of donor hearts available for transplant has remained stagnant. In 2010 there were 2 333 heart transplants performed in the United A severe donor shortage has limited the availability of donor hearts resulting in prolonged waits for organs for patients with advanced HF. Furthermore more than 200 000 patients with heart failure are not eligible for transplant due to age or The advent of mechanical circulatory support has decreased mortality and improved the quality of life for patients awaiting heart transplantation as well as for those ineligible for transplantation. INDICATIONS FOR MECHANICAL ASSIST DEVICES Mechanical assist devices are indicated for patients who are failing optimal medical therapy. When patients are exhibiting evidence of end-organ dysfunction despite optimal medical therapy mechanical assist devices should be considered. Mechanical assist devices are used for both acute and chronic HF. The National Institute of Health has developed profiles using data from Interagency Registry for Mechanically Assisted Circulatory Support INTERMACS to assist in clarification of target populations for mechanical assist devices Table 1 . There are three main indications for mechanical assist devices 1 bridge to myocardial recovery 2 bridge to cardiac transplantation and 3 destination therapy. Bridge to Recovery Mechanical assist devices are commonly used to support patients suffering from postcardiotomy shock that are unable to be weaned from cardiopulmonary bypass Chapter 8 Percutaneous Mechanical Support 111 1 INTERMACS profile description Clinical presentations Time frame for intervention Profile 1 Critical cardiogenic

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