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Use of Two Intracorporeal Ventricular Assist Devices As a Total Artificial Heart
08:49

Use of Two Intracorporeal Ventricular Assist Devices As a Total Artificial Heart

Published on: May 11, 2018

Heart transplant vs left ventricular assist device in heart transplant-eligible patients

Matthew L Williams1, Jaimin R Trivedi, Kelly C McCants

  • 1Division of Thoracic and Cardiovascular Surgery, University of Louisville, and Jewish Hospital Transplant Center, Louisville, Kentucky 40202, USA.

The Annals of Thoracic Surgery
|March 29, 2011
PubMed

Insights

One-year survival outcomes for patients awaiting heart transplantation were similar whether they received a left ventricular assist device (LVAD) as a bridge to transplant or underwent immediate heart transplantation. LVAD use did not negatively impact heart transplant outcomes.

Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Medical Devices

Background:

  • Patients awaiting heart transplantation face prolonged wait times, leading to clinical deterioration and significant mortality.
  • The effectiveness of left ventricular assist devices (LVADs) as a bridge to transplant (BTT) compared to immediate heart transplantation requires further evaluation.

Purpose of the Study:

  • To compare the 1-year outcomes and effectiveness of LVAD as a bridge to transplant versus immediate heart transplantation.
  • To assess the impact of prior LVAD support on subsequent heart transplant outcomes.

Main Methods:

  • A retrospective evaluation of patients listed for heart transplantation between January 2009 and December 2009.
  • Comparison of 1-year survival, hospital length of stay, and readmission rates between patients receiving LVAD for BTT and those undergoing immediate heart transplantation.
  • Statistical analyses included descriptive statistics, t-tests, and Kaplan-Meier survival curves.

Main Results:

  • One-year survival rates were similar between the LVAD BTT group (29 patients) and the heart transplant group (13 patients).
  • Hospitalization durations and readmission rates within 3 months were comparable between the two groups, with infection being the most common cause for readmission.
  • No in-hospital deaths occurred in either group, with 3 late deaths observed in the LVAD BTT group.

Conclusions:

  • One-year outcomes for heart transplant candidates are comparable whether they receive an allograft or utilize an LVAD as a bridge to transplant.
  • Prior LVAD support does not adversely affect subsequent heart transplant outcomes.
  • Current decision-making models for heart transplant eligibility may need reevaluation in light of improving LVAD outcomes.
Abstract

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