Related Experiment Videos
Long-term left ventricular assist device use before transplantation
J S Sapirstein1, W E Pae, T X Aufiero
1Department of Surgery, Pennsylvania State University College of Medicine, Hershey 17033, USA.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|July 1, 1995
Summary
Pneumatic, pulsatile left ventricular assist devices (LVADs) effectively bridge patients to heart transplantation. While complications occurred, LVADs demonstrated excellent outcomes for transplant candidates, particularly those with cardiomyopathy.
Area of Science:
- Cardiology
- Medical Devices
- Transplantation Surgery
Background:
- End-stage heart disease necessitates advanced support strategies.
- Left ventricular assist devices (LVADs) are crucial for bridging patients to cardiac transplantation.
- Pneumatic, pulsatile LVADs have been utilized in managing advanced heart failure.
Purpose of the Study:
- To evaluate the efficacy and outcomes of pneumatic, pulsatile LVADs in patients awaiting cardiac transplantation.
- To assess complication rates and survival in LVAD recipients.
- To identify patient populations with higher risks during LVAD support.
Main Methods:
- A retrospective analysis of 19 patients receiving pneumatic, pulsatile LVADs between September 1992 and April 1995.
- Data collection included patient demographics, underlying cardiac conditions, pre-LVAD support, perioperative management, complications, and transplant outcomes.
- Standard anticoagulation (heparin, warfarin) and a comprehensive exercise/nutrition protocol were employed.
Main Results:
- Fourteen of 19 (74%) patients underwent successful transplantation and were discharged.
- Major complications included bleeding (3), cerebrovascular accidents (3), and severe dysrhythmias (4).
- Patients with acute myocardial infarction (AMI) showed a higher mortality risk compared to those with cardiomyopathy.
Conclusions:
- Pneumatic, pulsatile LVADs provide excellent results as a bridge to transplantation for select end-stage heart disease patients.
- Right ventricular dysfunction did not necessitate additional right VAD support in this cohort.
- Prompt LVAD implementation within an interdisciplinary care framework is key to successful outcomes for transplant candidates.