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Mechanical circulatory support in severe heart failure: single-center experience
E Vitali1, M Lanfranconi, G Bruschi
1Department of Cardiac Surgery "Angelo De Gasperis," Niguarda Cà Granda Hospital, Milan, Italy. evitali@ospedaleniguarda.it
Transplantation Proceedings
|April 28, 2004
Summary
Ventricular assist devices (VADs) effectively bridge patients with end-stage heart failure to heart transplantation (HTx). Implantable VADs improve quality of life by allowing patients to return home during support.
Area of Science:
- Cardiology
- Medical Devices
- Mechanical Circulatory Support
Background:
- Ventricular assist devices (VADs) are crucial for end-stage cardiac failure, serving as a bridge to heart transplantation (HTx).
- Left ventricular VAD (LVAD) therapy is an alternative for non-transplant candidates and used for postcardiotomy failure, myocarditis, and myocardial infarction.
Purpose of the Study:
- To evaluate the effectiveness and outcomes of VAD therapy in patients with end-stage heart failure.
- To assess VADs as a bridge to HTx and as an alternative therapy.
Main Methods:
- Retrospective analysis of 80 patients receiving left or biventricular mechanical circulatory support between 1988 and May 2003.
- Data collected on patient survival, duration of VAD support, transplantation rates, recovery, adverse events, and discharge status.
Main Results:
- All 80 patients survived the initial operation; mean VAD support duration was 77 days.
- 63.8% underwent HTx, 3.8% recovered and were weaned off VADs.
- Major bleeding occurred in 13.8%, major neurologic events in 10%; 27.5% died on VAD support. 20% were discharged home.
Conclusions:
- VAD therapy is effective for bridging patients to HTx.
- Wearable implantable VADs can improve patient quality of life by enabling discharge home while awaiting transplantation.