15? 15 out of how many? That number seems a bit high unless the pt population you're in reference to is remarkably large. While I like the idea of the HeRo, I personally view it as a last resort when other measures have failed in both arms and both legs. My reasoning --- foreign body + heart = problems. I would think that with time the HeRo, as with TVC's, the vessels (namely the SVC) would develop intimal hyperplasia along with the obvious risk of difficult to treat infection. Yes, these risks are outwieghed by many other factors in certain cases (otherwise people wouldn't get pacemakers or other centrally implanted devices), but is the HeRo viewed as anything other than a last resort in your area?
The HeRO is to be used as the last resort. 15 seems really high for any facility. The most I have seen is 2 patients in a clinic with over 100 patients.
I have noticed that many of these HeRO grafts tend to clot very early after being implanted. The recommendation is that the patient has an EF >20% to be considered. Many of the patients at last resort don't fall into that group.
Yes the efract rate should be >20 and the Systolic BP >120 seems to work better,without clotting.As with any graft the potential for clotting is always present.The Hero is really a last resort when you have no other access except a catheter..The Hero is now classified by the FDA as a Graft.There has been extensive research done on de-clotting procedures for the Hero at Duke University in NC.PS the patient population was 978 ,3 clinics so 15 is not a large number.