Open AccessBridging Patients to Cardiac Transplantation
Author(s) -
Higginbotham Michael B.,
Russell Stuart D.,
Mehra Mandeep R.,
Ventura Hector O.
Publication year - 2000
Publication title -
congestive heart failure
Language(s) - English
Resource type - Journals
eISSN - 1751-7133
pISSN - 1527-5299
DOI - 10.1111/j.1527-5299.2000.80167.x
Subject(s) - medicine , decompensation , inotrope , intensive care medicine , transplantation , bridging (networking) , heart failure , heart transplantation , bridge to transplantation , medical therapy , clinical trial , cardiology , surgery , computer network , computer science
Potential recipients of heart transplants have the most advanced form of congestive heart failure, in which standard therapy fails to maintain clinical stability. In the absence of guidelines derived from evidence obtained in clinical trials, caring for these patients becomes a challenge. A successful approach requires the proper coordination of surgical and nonsurgical strategies, including revascularization and valvular surgery as well as mechanical ventricular support and medical strategies. Intensive medical therapy is the most commonly used approach for prolonged bridging to transplantation. Although carefully individualized regimens are necessary to achieve desired goals, most centers adopt a fairly standardized approach involving vasodilators, diuretics, and inotropic support. Bridging patients with cardiac decompensation to transplantation presents a major therapeutic challenge. Appropriate strategies will maximize patients' chances that the bridge from decompensation to transplantation remains intact.