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Outpatient left ventricular assist device support: a destination rather than a bridge
K A Catanese1, D J Goldstein, D L Williams
1Department of Surgery, College of Physicians & Surgeons, Columbia University, New York, New York, USA. catanes@cucis.cis.columbia.edu
The Annals of Thoracic Surgery
|September 1, 1996
Summary
Outpatient left ventricular assist devices (LVADs) are feasible for bridging heart transplant patients. Patients successfully managed LVADs at home, showing promise for long-term heart failure treatment.
Area of Science:
- Cardiology
- Medical Devices
- Transplantation Medicine
Background:
- Evaluating outpatient left ventricular assist devices (LVADs) as a bridge to transplantation.
- Reviewing initial clinical experience with LVADs at the institution.
Purpose of the Study:
- To assess the feasibility and efficacy of outpatient LVADs.
- To determine the safety and success of home management for LVAD patients.
Main Methods:
- A cohort of 14 patients (12 male, 2 female, average age 47) received Thermo Cardiosystems VE wearable LVADs.
- Patients were supported for an average of 117 days, with 7 discharged home after an average of 35 days.
Main Results:
- No LVAD device failures occurred, despite 29 controller malfunctions over 1,640 support days.
- Patients safely managed devices at home; readmissions were due to graft bleeding and driveline infection.
- No long-term anticoagulation was used, with only one minor thromboembolic event.
Conclusions:
- Hospital discharge for LVAD patients is feasible, enabling long-term technology evaluation.
- All 7 discharged patients survived and successfully managed their devices at home.
- Outpatient LVADs show potential as a long-term alternative to medical management for heart failure.