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The Annals of Thoracic Surgery, Vol 47, 102-107, Copyright © 1989 by The Society of Thoracic Surgeons

ARTICLES

Circulatory Support 1988. Weaning and bridging

GJ Magovern, LA Golding, PE Oyer and C Cabrol

After a patient has been supported with a circulatory assist device, the expected outcomes are weaning, bridging, or discontinuation of support. An early insertion of the device will avoid deterioration of the heart and other organs to an irreversible condition. Cardiac assistance for a minimum of 24 hours is recommended with a mild dose of anticoagulant. It is necessary to monitor the hemodynamic functions during circulatory support and weaning. Most of the mechanical devices are quite reliable, and complications during ventricular assist are easily managed. The patient should be in the same condition as in ordinary elective transplant candidate before transplantation. Patients with an artificial heart or ventricular assist device should not be on the priority emergency list for cardiac transplantation. Patients suffering from cardiogenic shock can be stabilized with a ventricular assist device to allow the heart to recover or be provided with other treatment. A circulatory support device can also be used as a bridge for patients awaiting a cardiac transplant.


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