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Clinical experience with 111 thoratec ventricular assist devices.
L R McBride1, K S Naunheim, A C Fiore
1Department of Surgery, Saint Louis University, Missouri 63110-0250, USA. mcbridlr@wpogate.slu.edu
The Annals of Thoracic Surgery
|June 4, 1999
Summary
Ventricular assist device (VAD) therapy shows promise for myocardial recovery and as a bridge to transplantation, but carries significant risks. Early and late results indicate challenges with bleeding, infection, and thromboembolism, impacting survival rates.
Area of Science:
- Cardiovascular Surgery
- Medical Devices
- Heart Failure Management
Background:
- Ventricular assist devices (VADs) are increasingly utilized due to improved patient selection, management, and device availability.
- This study reviews early and late outcomes of 111 patients treated with the Thoratec VAD.
Purpose of the Study:
- To evaluate the early and late results of Thoratec VAD implantation.
- To assess the efficacy and complications of VADs in patients undergoing myocardial recovery versus bridge to transplantation.
Main Methods:
- Retrospective review of 111 patients who received a Thoratec VAD.
- Analysis of patient demographics, VAD type (LVAD, BVAD, RVAD), duration of support, complications, and survival rates.
Main Results:
- For myocardial recovery (44 patients), mean age was 51.9 years; complications included bleeding (45%) and infection (2%). 12 of 19 weaned patients survived.
- For bridge to transplantation (67 patients), mean age was 41.5 years; complications included bleeding (31%), infection (18%), and thromboembolism (8.1%). 42 bridge survivors were achieved.
- Ten-year actuarial survival was 16% for recovery, 22% for bridge to transplantation, and 33% for transplanted patients.
Conclusions:
- VAD support, despite advancements, is linked to substantial morbidity and operative mortality.
- Careful patient selection and management are crucial for optimizing outcomes in VAD therapy.