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Therapeutic Strategies in Patients Suffering from Myocardiopathy (Awaiting Transplantation)

  • E. A. Bocchi
  • F. Bacal
  • J. O. Auler
Conference paper

Abstract

The Registry of the International Society for Heart and Lung Transplantation has shown that neither the donor supply nor the post transplantation survival have changed during the last 6 years [1]. Selection of patients for heart transplantation, which maximizes the survival benefit with respect to medical therapy result, is the main way to increase the impact of this procedure for treatment of heart failure. The mortality rate for patients awaiting cardiac transplantation, on optimal medical therapy, would be 25% to 50% at 1 year, 50% to 75% at 3 years, and 90% at 5 years [2]. Accordingly, patients waiting for heart transplantation are under high risk and should receive the maximal optimized treatment for heart failure. The therapeutic approach to heart failure is directed not just towards the relief of symptoms, but to avoid progression of heart failure or death. The therapeutic approaches to heart failure are multiple and include general measures, pharmacological therapy, the use of mechanical devices as well as alternative surgical interventions [3]. Adverse effects and interaction may preclude the use of some forms in some patients. Deterioration can require modification of the therapeutic approach. Treatment must be tailored according to the needs of each patient. Each month, 4.7% of the patients listed for heart transplantation as Status II (not requiring pharmacological or mechanical support), deteriorate to the point of requiring an upgrade in their priority status, and two thirds of patients who were Status I (requiring pharmacological or mechanical support) at the time of heart transplantation were Status II at the time they were listed [4].

Keywords

Chronic Heart Failure Heart Transplantation Implantable Cardioverter Defibrillator Cardiac Transplantation Severe Heart Failure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Italia, Milano 1998

Authors and Affiliations

  • E. A. Bocchi
  • F. Bacal
  • J. O. Auler

There are no affiliations available

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