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Related Experiment Videos

Univentricular versus biventricular assist device support.

D G Pennington1, J E Reedy, M T Swartz

  • 1Department of Surgery, St. Louis University Medical Center, Mo 63110-0250.

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|March 1, 1991
PubMed
Summary

The choice between univentricular assist devices (UVADs) and biventricular assist devices (BVADs) for heart failure patients should be selective. Survival depends on myocardial recovery or transplant eligibility, not solely on the number of devices used.

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Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Medical Device Technology

Background:

  • Ongoing debate exists regarding the optimal choice between univentricular assist devices (UVADs) and biventricular assist devices (BVADs) for patients with advanced heart failure.
  • The selection of assist device type may significantly impact patient outcomes, including mortality and morbidity.

Purpose of the Study:

  • To compare mortality and morbidity rates between patients receiving UVADs versus BVADs.
  • To evaluate the influence of device selection on survival in patients supported by Thoratec Ventricular Assist Devices (VADs).

Main Methods:

  • Retrospective analysis of data from 39 patients who received Thoratec VADs for over 48 hours.
  • Patients were categorized into two groups: UVAD (n=23) and BVAD (n=16).

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  • Comparison of demographic data (age, gender), duration of support, mortality, and morbidity between the UVAD and BVAD groups.

    • Main Results:

    • No significant differences were observed in age, gender, or duration of VAD support between the UVAD and BVAD groups.
    • Morbidity rates were comparable between patients receiving UVADs and BVADs.
    • Survival was primarily determined by the reversibility of pre-VAD myocardial damage and eligibility for heart transplantation, rather than the type of VAD used.

    Conclusions:

    • The study does not support the routine use of BVADs in all VAD patients.
    • A selective approach to VAD implantation, based on individual hemodynamic requirements, is recommended.
    • The type of VAD (UVAD vs. BVAD) is less critical for survival than addressing the underlying myocardial condition and transplant candidacy.