Surgical complications in bridging to transplantation: the Thermo Cardiosystems LVAD

Left ventricular assistance with a number of different devices has been used to successfully bridge patients to cardiac transplantation. Surgical complications or complications related to the device itself, however, may preclude transplantation or lead to death. We report our recent experience with the Thermo Cardiosystems model 14 "HeartMate" left ventricular assist device in 3 patients. The device was implanted for 15 to 95 days. Complications included mediastinitis and peritonitis associated with the device in place before transplantation, and colonic perforation, and a late diaphragmatic hernia after transplantation. Despite these and other minor complications, all 3 patients underwent successful cardiac transplantation. Mechanical support for the right ventricle was not necessary. The Thermo Cardiosystems left ventricular assist device provided excellent support in a range of physiological conditions with no mechanical malfunction despite the surgical complications.