Related Experiment Video
Updated: Jan 8, 2026
A High-Fidelity Porcine Model of Orthotopic Heart Transplantation Following Donation after Circulatory Death
Published on: June 6, 2025
Can Paracorporeal Bi-VAD Improve the Outcome of a Patient Candidate for Heart Transplant?
Giuseppe Fischetti1, Lorenzo Giovannico1, Federica Mazzone1
1Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari, Bari, Italy.
Background:
Postcardiotomy cardiogenic shock (PCCS) is a critical condition with high mortality. When biventricular dysfunction occurs, veno-arterial ECMO alone may not provide adequate unloading. Paracorporeal BiVAD can offer balanced support as a bridge to heart transplantation.
Case:
A 61-year-old woman developed PCCS following bioprosthetic aortic valve replacement. Despite VA-ECMO and intra-aortic balloon pump support, biventricular failure persisted. A paracorporeal BiVAD was implanted, achieving rapid hemodynamic and pulmonary improvement. After 7 days of BiVAD support, she underwent successful orthotopic heart transplantation. At 1-year follow-up, the patient remains alive without graft rejection or vasculopathy.
Conclusion:
Early conversion from VA-ECMO to BiVAD may improve outcomes in refractory PCCS with biventricular failure, serving as an effective bridge to transplantation.
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