Ventricular assist devices and total artificial hearts: a combined registry experience

Data submitted voluntarily to the combined registry for the past 6 years on the use of ventricular assist devices for postcardiotomy cardiogenic shock in 965 patients and for circulatory support in conjunction with cardiac transplantation in 544 patients were analyzed. Of those patients whose ventricular function was expected to recover, approximately 45% were weaned from circulatory support and 25% were discharged from the hospital. Weaning status and hospital discharge were not different regardless of the type of original operative procedure or the pump design used. In the potential cardiac transplant group, 69% ultimately underwent transplantation and 66% were discharged from the hospital. The demographics (age and sex) of this group parallel those of patients undergoing isolated cardiac transplantation, and the 1- and 2-year survival estimates for patients requiring only univentricular support were equivalent to those of patients having isolated orthotopic cardiac transplantation. Ventricular assist devices are able to provide reasonable and safe circulatory support in both the postcardiotomy cardiogenic shock and the bridge-to-transplantation applications.