[Ventricular assist devices as a bridge to transplantation]

We carried out an analysis of the results obtained in patients (n=23) who received a ventricular assist device before heart transplantation between 1988 and 2005. Their mean age was 52.5 (8.4) years. Reasons for inclusion in the transplantation waiting list were postcardiotomy referral (n=10), myocardial infarction (n=5), primary graft dysfunction (n=7), and dilated cardiomyopathy (n=1). Different types of ventricular assist device were used: the Abiomed 5000 (n=13), the Biomed Comunidad de Madrid (n=9), and the BioMedicus (n=1). The mean transplantation waiting time was 3.0 (2.4) days. In-hospital complications were neurological (n=7), infectious (n=12), renal (n=3), hemorrhagic (n=3), and respiratory (n=2). In-hospital mortality was 39.1% (n=9). Kaplan-Meier analysis gave a 1-year survival rate of 55.2% and a 5-year survival rate of 32.2%. In patients who were discharged home, the 1-year survival rate was 92.3%. Careful patient selection is essential for obtaining good results.