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Bridge to transplantation: the Penn State experience
D Mavroidis1, B C Sun, W E Pae
1Department of Surgery, The Milton S. Hershey Medical Center, The Penn State Geisinger Health System, Hershey 17033-0850, USA.
The Annals of Thoracic Surgery
|September 4, 1999
Summary
Ventricular assist devices (VADs) are effective for bridging patients to heart transplantation. Outcomes were similar between the HeartMate 1000 IP and Thoratec systems, with a preference for HeartMate due to portability and quality of life.
Area of Science:
- Cardiovascular Surgery
- Medical Devices
- Transplantation Medicine
Background:
- Ventricular assist devices (VADs) have evolved from experimental to accepted therapy for bridging patients to heart transplantation.
- Our institution has extensive experience with FDA-approved VADs used in bridge-to-transplantation programs.
Purpose of the Study:
- To present institutional perspectives on the advantages and disadvantages of two VADs: Thermo-Cardiosystems HeartMate 1000 IP and Thoratec (Pierce-Donachy) system.
- To discuss patient selection, perioperative management, and outcomes in a bridge-to-transplantation program.
Main Methods:
- Review of over 60 VAD implantation procedures within a bridge-to-transplantation program.
- Discussion of patient selection, preoperative, intraoperative, and postoperative management protocols.
- Comparison of the Thermo-Cardiosystems HeartMate 1000 IP and Thoratec (Pierce-Donachy) systems.
Main Results:
- Two-thirds of patients in the program were successfully bridged to heart transplantation.
- Post-transplantation survival rates were 92% at 1 month and 83% at 1 year.
- Both VAD systems demonstrated effectiveness in supporting patients to transplantation.
Conclusions:
- Both HeartMate 1000 IP and Thoratec VADs are effective for bridging patients to heart transplantation.
- A preference for the HeartMate 1000 IP exists due to its portability and improved patient quality of life.
- The Thoratec device offers greater versatility, making it advantageous in specific clinical scenarios. Overall outcomes were not device-dependent.