State of the art of the mechanical circulatory device therapy in Hungary – the Városmajor experience
█ Original article
Hartyánszky István, Sax Balázs, Fazekas Levente, Szabolcs Zoltán, Horkay Ferenc, Heltai Krisztina, Németh Endre, Hüttl Tivadar, Pólos Miklós, Daróczi László, Kőszegi Andrea, Tóth Roland, Barabás J. Imre, Benke Kálmán, Kovács Péter, Merkely Béla
Semmelweis Egyetem, Városmajori Szív- és Érgyógyászati Klinika, Budapest
*Semmelweis Egyetem, Aneszteziológiai, és Intenzív Terápiás Klinika, Budapest
Parallel to the 25 years of success in the Hungarian transplant program, in the last 5 years we built up a comprehensive mechanical circulatory support (MCS) program. Infrastructural and human resource development at the Heart and Vascular Center of Semmelweis University – including the establishment of a dedicated intensive care unit for heart failure therapies and heart transplantation – made the success of our advanced heart failure therapies program available. Now we provide the full spectrum of mechanical circulatory support in all indications and bridging strategies including short, mid and long term support.
In the last five years, we treated 140 patients with severe heart failure refractory to medical therapy with a total of 185 device implantations. Indications were primary graft failure after cardiac transplant (n=50), acute decompensation of chronic heart failure (n=64), post-myocardial infarction cardiogenic shock (n=41), post-cardiotomy syndrome (n=25), severe respiratory insufficiency (n=4) and drug toxicity induced ventricular tachyarrhythmia (n=1). We were able to bridge the majority of these patients to recovery, heart transplant or in certain cases until upgraded MCS therapy. We implanted 26 long term device as a bridge to transplant strategy with excellent results.