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Mechanical circulatory support in advanced heart failure: single-center experience
A Loforte1, A Montalto1, P Lilla della Monica1
1Department of Cardiac Surgery and Transplantation, S Camillo Hospital, Rome, Italy.
Transplantation Proceedings
|June 18, 2014
Summary
Mechanical circulatory support, including ventricular assist devices (VADs) and total artificial hearts (TAHs), offers an effective treatment for advanced heart failure. This technology shows promise as an alternative to heart transplantation.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Biomedical Engineering
Background:
- Mechanical circulatory support (MCS) with ventricular assist devices (VADs) or total artificial hearts (TAHs) is a critical treatment for advanced heart failure.
- This study reports a single-center experience with MCS therapy in patients with refractory heart failure.
Purpose of the Study:
- To evaluate the effectiveness and outcomes of temporary and long-term VAD/TAH support in patients with end-stage heart failure.
- To assess the role of MCS as a bridge to heart transplantation or as destination therapy.
Main Methods:
- A retrospective analysis of 107 adult patients undergoing VAD or TAH support between March 2002 and December 2012.
- Patients were categorized into temporary extracorporeal support (Group A) and long-term paracorporeal/intracorporeal support (Group B).
- Specific devices included LVADs, biventricular VADs/TAHs, and RVADs, with detailed device types and patient numbers provided.
Main Results:
- Group A (temporary support) had a mean support duration of 10.2 days with a 55.1% success rate.
- Group B (long-term support) showed higher success rates: 74.4% for LVAD and 50% for BVAD/TAH.
- Overall heart transplantation rates were 27.1%, with 1-year and 5-year survival rates post-transplant of 72.4% and 58.6%, respectively.
Conclusions:
- Mechanical circulatory support is an effective strategy for end-stage heart failure.
- Advancements in VAD and TAH technology may position MCS as a viable alternative to heart transplantation in the future.
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