Mechanical circulatory support as a bridge to cancer therapy in patients with end stage heart failure: a single center experience.

Using mechanical circulatory support in end-stage heart failure patients is an important emerging indication for bridging to cancer therapy. This is crucial for survival in end stage heart failure patients with cancer, allowing chemotherapy and surgery. The utility of both temporary and durable mechanical circulatory support is demonstrated in this retrospective analysis of four cases presented here. This approach highlights a multidisciplinary, proactive management strategy for co-existing, life-limiting conditions. Mechanical circulatory support is useful in selected patients who need curative treatments. One of the important messages learnt from these cases is that a multidisciplinary approach improves quality of life as outpatients and reduces the frequency of hospitalization, challenging the notion that active cancer is an absolute contraindication. Contemporary smaller pumps have lower shear stress and reduced damage to blood cell components, but future research is warranted in this area to optimize anticoagulation protocols because cancer patients with end stage heart failure are at high risk for bleeding and thrombosis.