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Updated: Jul 8, 2026
Implantation of the Syncardia Total Artificial Heart
Published on: July 18, 2014
Kinetic assisted venous drainage for orthotopic heart transplantation in patients under mechanical circulatory
Matthias E W Kirsch1, Zannis Kostantinos, Firas Ali
1Service de Chirurgie Thoracique et Cardiovasculaire, AP-HP, Hôpital Henri Mondor, Créteil, France. matthias.kirsch@hmn.aphp.fr
Background:
Heart transplantation in patients supported with ventricular assist devices (VADs) entails a high risk of injury at resternotomy. Prior femorofemoral bypass is the preferred approach in these patients, but poor venous drainage may restrict arterial flow rate.
Patients And Methods:
We compared bypass parameters, transfusion requirements and postoperative outcome in 33 consecutive patients (40.4+/-12.2 years old, 28 men) assisted with the Thoratec paracorporeal VAD (mean duration, 3.0+/-2.96 months) undergoing transplantation using either gravity siphon drainage (GSD, n=16) or kinetic assisted venous drainage (KAVD, n=17).
Results:
Cannulation technique, perfusion pressure, temperature and duration were similar between groups. There were no significant differences in arterial re-infusion flow rates (GSD, 3.6+/-0.7 vs KAVD, 3.8+/-0.6l/min, p=0.5). KAVD patients had a lower mean S(v)O(2) and a higher desaturation index than GSD patients (69.5+/-4.6 vs 76.1+/-5.4mmHg, p=0.004; and 0.63+/-0.23 vs 0.25+/-0.63, p=0.0001, respectively). Perioperative requirements in fresh frozen plasma and platelet transfusions were significantly higher in KAVD patients. However, there were no differences in postoperative patient outcome.
Conclusion:
Perceived benefits on venous return associated with KAVD do not necessarily translate into improved arterial re-infusion flow rates and should be weighed against the hazards of increased venous air aspiration and blood product requirements.
