A ventricular assist device bridges the way to a new life

Cardiac transplantation is a recognized and lifesaving treatment for those unresponsive to all other available treatments (Hosenpud JD, Bennett LE, Kech BM, Boucek MM, Novick RJ. The registry of the International Society for Heart and Lung Transplantation: eighteenth official report-2001. J Heart Lung Transplant. 2001;20:805-815). The number of transplants performed in the United States grows steadily yearly with improving drugs for infection and rejection, the 2 most common medical complications and still the primary causes of death in long-term follow-up (Zugibe F, Costello J, Breithaupt M, Segalbacher J. Model organ description protocols for completion by transplant surgeons using organs procured from medical examiner cases. J Transplant Coord. 1999;9:73). Sometimes, getting the patient to the transplant process is in itself a struggle. As the need for heart transplants increase across the nation, donor hearts have not increased, even with more awareness in the medical community. Therefore, our struggle remains with keeping the patient alive, stable, and in the best position for transplantation when the perfect donor heart arrives. As critical care nurses, we see this bridge to transplantation in the form of pharmaceutical agents and/or mechanical assist devices (Scherr K, Jensen L, Koshal A. Mechanical circulatory support as a bridge to cardiac transplantation: towards the 21st century. Am J Crit Care. 1999;8:324-337). The patient waits patiently for a donor heart to be available, but is becoming weaker in the process. We wish to see those hearts come sooner and healthier. In truth, this in not usually seen. Sometimes the wish comes true, and with the help of nurses, doctors, ancillary departments, and even multiple hospital systems pulling together a miracle can still happen.