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Outpatients on biventricular assist devices
1Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, 13353 Berlin, Germany. dr.drews@berlin.de
The Thoracic and Cardiovascular Surgeon
|October 18, 2001
Summary
Long-term use of the biventricular assist device (BVAD) is feasible for patients awaiting heart transplants. This mechanical circulatory support enables recovery and improves quality of life before transplantation.
Area of Science:
- Cardiology
- Medical Engineering
Background:
- Increasing transplant waiting times necessitate advanced therapies for severe cardiogenic shock.
- Mechanical circulatory support (MCS) is crucial for patients with multiorgan failure.
Purpose of the Study:
- To evaluate the feasibility and outcomes of outpatient use of the biventricular assist device (BVAD) as a bridge to heart transplantation.
- To assess patient safety, recovery, and quality of life during home-based BVAD support.
Main Methods:
- Retrospective analysis of 11 patients implanted with BVAD (Berlin Heart) between 1997 and 2000.
- Patients were discharged home after recovery from organ dysfunction and training in device management.
- Monitoring included infections, thromboembolic events, bleeding, and psychological effects.
Main Results:
- All 11 patients were discharged home, with a mean support time of 382 days.
- The mean duration of home support was 48 days.
- Readmission occurred in 63% of patients (transient ischemic attacks, bleeding, wound infections); one patient died from an accident.
Conclusions:
- Outpatient BVAD support is a viable strategy for patients awaiting transplantation.
- It facilitates survival, organ recovery, and an acceptable quality of life.
- Careful patient selection and training are essential for successful home management.