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Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
Published on: August 16, 2021
Left Ventricular Assist Device Results: Single Center Experience
Bahadir Gultekin1, Ozgur Ersoy, Murat Ozkan
1From the Department of Cardiovascular Surgery, Baskent University Faculty of Medicine, Ankara, Turkey 06490.
Insights
Left ventricular assist devices (LVADs) are increasingly used for end-stage heart failure due to limited heart donations. This study shows LVADs as a viable option for patients awaiting transplant, despite a 33.3% mortality rate.
Area of Science:
- Cardiology
- Medical Devices
- Transplantation
Background:
- Increasing prevalence of end-stage heart failure and limited donor hearts necessitate alternative treatments.
- Left ventricular assist devices (LVADs) are emerging as a crucial option for managing advanced cardiac conditions.
Purpose of the Study:
- To evaluate the outcomes of patients receiving HeartWare LVAD implants at Baskent University Ankara Hospital.
- To assess the efficacy and complications of LVADs as destination therapy and bridge to transplant.
Main Methods:
- Retrospective analysis of 24 patients implanted with HeartWare LVADs between April 2012 and February 2015.
- Data collected included patient demographics, etiology of heart failure, LVAD support type, and adverse events.
Main Results:
- The study included 24 patients with heart failure due to ischemic (45%) or dilated cardiomyopathy (50%).
- 10 patients (41.6%) received LVADs for destination therapy, and 14 (48.6%) for bridge to transplant.
- The mortality rate was 33.3% (8 patients), with 3 patients receiving heart transplants and 1 recovering.
Conclusions:
- LVADs represent a critical therapeutic option for end-stage heart failure patients awaiting transplantation.
- Given donor organ scarcity, LVADs offer a life-sustaining solution, improving outcomes for eligible candidates.
Objectives:
The number of patients with end-stage cardiac failure who are waiting for transplant has been increasing, although number of heart donations stays limited. This has resulted in an increased use of left ventricular assist devices. Here, we present results of patients who received left ventricular assist device implants at Baskent University Ankara Hospital.
Materials And Methods:
We retrospectively evaluated 24 patients who received a HeartWare left ventricular assist device (HeartWare Inc, Framingham, MA, USA) between April 2012 and February 2015; 2 patients (8.33%) were female.
Results:
Patients had end-stage heart failure as a result of the following causes: 11 patients (45%) had ischemic cardiomyopathy, 12 patients (50%) had dilated cardiomyopathy, and 1 patient (4.1%) had acute myocarditis. Regarding use of the left ventricular assist device, 10 patients (41.6%) had the device as destination therapy, and the remaining 14 patients (48.6%) had it as bridge to transplant. The Interagency Registry for Mechanically Assisted Circulatory Support Profile was 1 for 3 patients (12.5%), 2 for 9 patients (37.5%), and 3 for 12 patients (50%). Mean follow-up was 239.8 days, and the mortality rate was 33.3% (8 patients died). During follow-up, we found that 3 patients (12.5%) had received a heart transplant and 1 patient (4.1%) eventually recovered, with the device extracted. Six patients had driveline infections, and 3 patients had cerebrovascular events.
Conclusions:
With the insufficient number of cardiac donors, use of a left ventricular assist device for patients with end-stage cardiac failure who are awaiting transplant may be the best option.
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