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Name and describe the 3 accepted indications for using mechanical circulatory support

Name and describe the 3 accepted indications for using mechanical circulatory support. 1) Bridge to myocardial recovery: less than 2 week circulatory support needed until pt recovers from acute event such as MI, viral myocarditis or failure to wean from CPB

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Name and describe the 3 accepted indications for using mechanical circulatory support

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  1. Name and describe the 3 accepted indications for using mechanical circulatory support

  2. 1) Bridge to myocardial recovery: less than 2 week circulatory support needed until pt recovers from acute event such as MI, viral myocarditis or failure to wean from CPB • 2) Bridge to transplant: unlikely to recover from acute MI, end-stage CHF from any source, myocarditis yet are candidates for orthotopic heart transplant • 3) Destination therapy: same as number 2, but not candidates for OHT and require permanent circulatory support

  3. List some contraindications to mechanical circulatory support:

  4. Irreversible renal, hepatic, or respiratory failure; Severe COPD or restrictive lung disease; sepsis; pulmonary hypertension refractory to vasodilators; significant cognitive deficits; portal hypertension and/or cirrhosis; age > 70

  5. List the possible complications of the IABP:

  6. Thrombosis, embolization, leg ischemia, balloon rupture, pseudoaneurysm, bleeding, sepsis, aortic dissection, lymph fistula, femoral neuropathy

  7. Which of the following are risk factors for developing leg ischemia with the IABP? • A) PVD • B) female gender • C) smoking • D) obesity • E) cardiogenic shock • F) All of the above

  8. Which of the following are risk factors for developing leg ischemia with the IABP? • A) PVD • B) female gender • C) smoking • D) obesity • E) cardiogenic shock • F) All of the above

  9. Which of the following are effects of the IABP? • A) reduction of preload • B) reduction of afterload • C) decreased coronary perfusion pressure • D) worsening of AI • E) Distorting your radial A-line tracing • F) All of the above

  10. Which of the following are effects of the IABP? • A) reduction of preload: no significant effect • B) reduction of afterload • C) Increased coronary perfusion pressure • D) worsening of AI • E) Distorting your radial A-line tracing • F) All of the above

  11. All of the following are potential effects of ECMO except: • A) bleeding • B) infection/sepsis • C) stroke • D) myocardial remodeling • E) SIRS

  12. All of the following are potential effects of ECMO except: • A) bleeding • B) infection/sepsis • C) stroke • D) myocardial remodeling • E) SIRS

  13. The following are major risks for bleeding s/p mechanical device implantation, except: • A) hepatic failure • B) prolonged CPB times • C) multiple cannulation sites • D) fibrinolysis from contact with biomaterials • E) acute renal failure

  14. The following are major risks for bleeding s/p mechanical device implantation, except: • A) hepatic failure • B) prolonged CPB times • C) multiple cannulation sites • D) fibrinolysis from contact with biomaterials • E) acute renal failure

  15. The single most important contributor to mortality while on long term (> 2 weeks) LVAD support is ___________ and it begins at __________.

  16. The single most important contributor to mortality while on long term (> 2 weeks) LVAD support is infection and it begins at the driveline exit site.

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