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HeartMate left ventricular assist device as bridge to heart transplantation

Koul, Bansi LU ; Solem, Jan Otto LU ; Steen, Stig LU ; Casimir-Ahn, H; Granfeldt, H and Lonn, U J (1998) In Annals of Thoracic Surgery 65(6). p.1625-1630
Abstract
BACKGROUND: Because of the limited supply of donor hearts, prospective recipients continue to die while on the waiting list for heart transplantation. Use of long-term mechanical circulatory support devices as a bridge to transplantation may reduce this mortality. However, with the present state of technology, continued clinical evaluation of the various long-term, mechanical circulatory support devices available is mandatory. METHODS: Sixteen patients were bridged with the HeartMate left ventricular assist device (LVAD) to heart transplantation for New York Heart Association functional class IV cardiac failure. Twelve pneumatic and six electric devices were used. The mean cardiac index and the mean pulmonary vascular resistance of the... (More)
BACKGROUND: Because of the limited supply of donor hearts, prospective recipients continue to die while on the waiting list for heart transplantation. Use of long-term mechanical circulatory support devices as a bridge to transplantation may reduce this mortality. However, with the present state of technology, continued clinical evaluation of the various long-term, mechanical circulatory support devices available is mandatory. METHODS: Sixteen patients were bridged with the HeartMate left ventricular assist device (LVAD) to heart transplantation for New York Heart Association functional class IV cardiac failure. Twelve pneumatic and six electric devices were used. The mean cardiac index and the mean pulmonary vascular resistance of the patient cohort were 1.71 x min(-1) x m(-2) and 3.1 Wood units, respectively. RESULTS: The mean LVAD support time per transplanted patient was 237 days, with a cumulative LVAD support time of about 7.2 years. Bleeding was the main operative and postoperative complication. Two patients suffered from neurologic complications and there were two major incidents of device malfunction. Twelve patients (75%) now have received a transplant, 3 (19%) are awaiting a transplant, and in 1 patient (6%), the device was explanted after spontaneous left ventricular recovery. Eleven of the 12 patients who received a transplant are alive and doing well. The HeartMate LVAD gave adequate circulatory support over extended periods of time and reversed the vital organ dysfunction. Since the start of the LVAD program, only 1 patient has died on our heart transplantation waiting list, compared to nine deaths in the 2 preceding years. CONCLUSIONS: The HeartMate LVAD bridge to heart transplantation can be performed with low post-LVAD implantation and posttransplantation mortality and offers 1- and 2-year posttransplantation actuarial survival rates comparable to those for nonbridged heart transplant recipients. (Less)
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author
organization
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type
Contribution to journal
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published
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in
Annals of Thoracic Surgery
volume
65
issue
6
pages
1625 - 1630
publisher
Elsevier
external identifiers
  • pmid:9647070
  • scopus:0031838653
ISSN
1552-6259
language
English
LU publication?
yes
id
fe469ffc-11a3-4e10-a826-f93ed13b07a3 (old id 1113933)
alternative location
http://ats.ctsnetjournals.org/cgi/content/abstract/65/6/1625
date added to LUP
2008-07-16 14:04:42
date last changed
2017-01-01 04:42:45
@article{fe469ffc-11a3-4e10-a826-f93ed13b07a3,
  abstract     = {BACKGROUND: Because of the limited supply of donor hearts, prospective recipients continue to die while on the waiting list for heart transplantation. Use of long-term mechanical circulatory support devices as a bridge to transplantation may reduce this mortality. However, with the present state of technology, continued clinical evaluation of the various long-term, mechanical circulatory support devices available is mandatory. METHODS: Sixteen patients were bridged with the HeartMate left ventricular assist device (LVAD) to heart transplantation for New York Heart Association functional class IV cardiac failure. Twelve pneumatic and six electric devices were used. The mean cardiac index and the mean pulmonary vascular resistance of the patient cohort were 1.71 x min(-1) x m(-2) and 3.1 Wood units, respectively. RESULTS: The mean LVAD support time per transplanted patient was 237 days, with a cumulative LVAD support time of about 7.2 years. Bleeding was the main operative and postoperative complication. Two patients suffered from neurologic complications and there were two major incidents of device malfunction. Twelve patients (75%) now have received a transplant, 3 (19%) are awaiting a transplant, and in 1 patient (6%), the device was explanted after spontaneous left ventricular recovery. Eleven of the 12 patients who received a transplant are alive and doing well. The HeartMate LVAD gave adequate circulatory support over extended periods of time and reversed the vital organ dysfunction. Since the start of the LVAD program, only 1 patient has died on our heart transplantation waiting list, compared to nine deaths in the 2 preceding years. CONCLUSIONS: The HeartMate LVAD bridge to heart transplantation can be performed with low post-LVAD implantation and posttransplantation mortality and offers 1- and 2-year posttransplantation actuarial survival rates comparable to those for nonbridged heart transplant recipients.},
  author       = {Koul, Bansi and Solem, Jan Otto and Steen, Stig and Casimir-Ahn, H and Granfeldt, H and Lonn, U J},
  issn         = {1552-6259},
  language     = {eng},
  number       = {6},
  pages        = {1625--1630},
  publisher    = {Elsevier},
  series       = {Annals of Thoracic Surgery},
  title        = {HeartMate left ventricular assist device as bridge to heart transplantation},
  volume       = {65},
  year         = {1998},
}