EAN: 9783642959813

QUALITY OF LIFE AND PSYCHOSOMATICS KARTONIERT (TB)

Advances in heart surgical treatment have been impressive in the last 15 years. In end-stage
heart disease  procedures are now performed routinely which were only experimental one or two
decades ago. Heart transplantation has become a well-established procedure. According to the
Gen eral Registry of the International Society of Heart and Lung Transplantation. 40 738 heart
transplantations had been performed through the end of 1997 with survival rates of 78 % at one
year  65 % at five years  and 42 % at ten years. The progress in this field has been due to
intense efforts in understanding and modulating immune responses to the trans planted heart  to
elaborate therapeutic strategies to constrain infections  and to improved out-patient care.
Accordingly  heart transplantation is integrated into the facilities of the health care systems
the routine of physicians  and the awareness of patients. The resulting increase in potential
organ recipients has not been met  however  by an equivalent increase of available donor
organs. This increasing discrepancy has forced the technical improvement and clinical evalua
tion of mechanical circulatory support systems as an option for treatment of critically ill
patients with a failing heart. Initially  these assist devices were only used to maintain
sufficient circulation in post-cardiotomy heart failure until myocardial function had recov
ered. Since the late 1980s  their primary use has been that of bridging patients with heart
failure until a suitable organ is available so that heart transplantation can be performed.

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