Riabilitazione cardiologica di pazienti con supporto circolatorio mediante dispositivo di assistenza ventricolare sinistra: Esperienza preliminare dopo impianto di sistema a flusso continuo come "destination therapy" in tre pazienti con scompenso cardiaco avanzato

Translated title of the contribution: Cardiac rehabilitation of patients with left ventricular assist device as "destination therapy"

Francesco Fattirolli, Massimo Bonacchi, Costanza Burgisser, Tommaso Cellai, Sara Francini, Serafina Valente, Guido Sani, Gian Franco Gensini

Research output: Contribution to journalArticle

Abstract

"End stage" heart failure is unresponsive to conventional pharmacological and non pharmacological treatments and has a bad prognosis either regarding survival or quality-of-life; besides cardiac transplantation is limited by organ shortage. Therefore mechanical devices have been developed, initially as "bridge to transplantation" and, more recently, as "destination therapy": definitive treatment for non-transplantable patients. In these patients instrumental evaluation, treatment and rehabilitation are not yet defined and standardized. This paper reports the initial experience realized, as a part of a regional cooperation project within Florence and Siena University Hospitals activities, with the first three male patients, aged 45 to 70 years, affected by end-stage heart failure (NYHA class IV), non-eligible to transplantation, and implanted with Jarvik Flowmaker 2000, an intraventricular axial-flow VAD generating a continuous blood flow. After clinical stabilization, patients underwent a specific evaluation and treatment purposely designed for these subjects during ICU and post-ICU stay and, subsequently, a formal cardiac rehabilitation program. Hemodynamic, bioumoral and functional parameters were recorded at the beginning, during and at the end of intensive rehabilitation program. All patients completed the program, achieving a remarkable and meaningful functional recovery, such to allow them going home, continuing with a self-activity with weekly follow-up in the Rehabilitation Center. The experience acquired by following these patients longitudinally - from the VAD implantation to hospital discharge - allowed us to develop a flow-chart divided in five phases, identifying the main clinical problems, the rehabilitative treatment goals and the useful indicators to define criteria for shift from every phase to the following one.

Translated title of the contributionCardiac rehabilitation of patients with left ventricular assist device as "destination therapy"
Original languageItalian
Pages (from-to)190-199
Number of pages10
JournalMonaldi Archives for Chest Disease - Cardiac Series
Volume72
Issue number4
Publication statusPublished - Dec 2009

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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