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Current Status of Heart Assist and Replacement in Taiwan
Author(s) -
Wang ShoeiShen,
Chu ShuHsun
Publication year - 1996
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/j.1525-1594.1996.tb00684.x
Subject(s) - medicine , cardiogenic shock , extracorporeal membrane oxygenation , heart transplantation , transplantation , heart failure , cardiotomy , survival rate , ventricular assist device , mortality rate , surgery , cardiology , myocardial infarction , cardiopulmonary bypass
The first clinical application of intraaortic balloon pumps (IABP) in Taiwan was in 1976 to treat post‐cardiotomy cardiogenic shock. It is now the most commonly used circulatory assist. From 1991 to 1995, 186 patients received IABP support with an overall mortality rate of 41.9%. The male patients had the best survival rate, 67%, after coronary artery bypass grafting. The first extracorporeal membrane oxygenation (ECMO) was in 1987 to treat intractable heart failure caused by severe acute rejection after heart transplantation. Because of poor outcome, patients only received ECMO sporadically during the past years. From November 1994 to November 1995, 30 patients received ECMO support with 50% of them eventually weaned from ECMO and 27% discharged. For short‐term support or emergency rescue, ECMO was a good choice. When long‐term support was required, the ventricular assist device (VAD) was a more suitable assist. One patient who received Thermedics VAD developed right heart failure and finally died of sepsis and multiple organ failure. VAD should be implanted before the secondary organ failure. The first successful clinical heart transplantation in Taiwan was performed on July 17, 1987. From 1991 to 1995, 102 patients underwent heart transplantation. The operative mortality was 3.9%, and the 1 and 5 year actuarial survival rates were 86 ± 3% and 77 ± 5%, respectively. To improve the success rate of clinical heart transplantation, organ donation should be encouraged.