Bridging to cardiac transplantation.

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering
• Transplantation Medicine

Background:

• Prosthetic ventricles and artificial hearts have been utilized for bridging to transplantation for four years.
• Patients requiring a bridge to transplantation often face rapid deterioration or sudden cardiac decompensation, such as massive myocardial infarction with cardiogenic shock.
• Careful patient selection is paramount to ensure suitability for heart transplantation despite their critical condition.

Purpose of the Study:

• To compare the outcomes of various artificial heart devices used for bridging to cardiac transplantation.
• To evaluate the efficacy of different prosthetic ventricles in managing patients with end-stage heart failure awaiting transplantation.

Main Methods:

• Review and comparison of clinical results from available bridging devices.
• Analysis of patient selection criteria for cardiac transplantation in deteriorating candidates.
• Inclusion of devices such as the centrifugal pump, Jarvik-7 orthotopic prosthetic ventricle, and heterotopic prosthetic ventricles (Thoratec, Novacor, Thermedics).

Main Results:

• The study compares the performance of different artificial heart technologies.
• Outcomes are assessed for patients bridging to transplantation using various prosthetic ventricular devices.
• The selection of appropriate candidates who are good transplant recipients despite rapid decline is highlighted.

Conclusions:

• The use of prosthetic ventricles and artificial hearts provides a vital option for bridging to transplantation.
• Effective patient selection is critical for optimizing outcomes in this high-risk population.
• Comparative data on available devices aids in clinical decision-making for artificial heart support.