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Is mechanical circulatory support helpful before cardiac retransplantation?
P Noirhomme1, Y d'Udekem, L Jacquet
1Department of Cardiovascular and Thoracic Surgery, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Cardiovascular Surgery (London, England)
|January 10, 1998
Summary
Ventricular assist devices (VADs) aid late heart retransplantation survival but do not improve outcomes for early retransplantation. VADs are not recommended for early retransplantation cases.
Area of Science:
- Cardiology
- Transplantation Medicine
- Medical Devices
Background:
- Ventricular assist devices (VADs) are crucial in managing end-stage heart failure.
- VADs serve as a bridge to cardiac transplantation for many patients.
Purpose of the Study:
- To retrospectively evaluate the impact of VADs on survival after early (<30 days) and late (>30 days) heart retransplantation.
- To determine the efficacy of VADs in improving outcomes for retransplanted patients.
Main Methods:
- Retrospective analysis of 219 cardiac transplantations over 10 years.
- Focus on 11 retransplanted patients, 8 of whom received preoperative VADs.
- Categorization of VAD implantation into early (<30 days) and late (>30 days) periods post-transplant.
Main Results:
- Five VADs were implanted in the early retransplantation period, with 2 survivors and 3 deaths.
- Three VADs were implanted in the late retransplantation period, with all patients surviving (mean follow-up 25 months).
- VADs demonstrated benefit in late retransplantation but not in early retransplantation.
Conclusions:
- Ventricular assist devices are beneficial for patients undergoing late heart retransplantation.
- VADs do not improve the poor survival rates associated with early retransplantation.
- The use of VADs for early retransplantation is not recommended.