Long-term mechanical circulatory support

Against the background of an increasing number of patients waiting for heart transplantation but a stagnating number of transplant procedures, long-term mechanical circulatory support is gaining major importance. We investigated the outcome of 20 patients (15 men, and 5 women, aged between 15 and 66 years) each supported for more than 100 days between September 1987 and August 1996. The indications for implantation were bridging in 17 patients, myocarditis in 2 patients, and postcardiotomy cardiogenic shock in one patient. 12 patients received the Novacor IVAD, 4 patients the Thoratec system, 3 patients the HeartMate device and one patient both Novacor and Thoratec. Mean duration of support was 178.1 days, 15 patients were transplanted, 14 of them could be discharged, 2 patients died, 4 patients are still waiting. The most frequent complication was device-related infection in 11 patients. The results have shown that all three systems are safe and reliable devices for supporting patients for more than 100 days.