Comparison of the CardioWest total artificial heart, the novacor left ventricular assist system and the thoratec ventricular assist system in bridge to transplantation

被引:50
作者
Copeland, JG
Smith, RG
Arabia, FA
Nolan, PE
Mehta, VK
McCarthy, MS
Chisholm, KA
机构
[1] Univ Arizona, Sarver Heart Ctr, Tucson, AZ 85724 USA
[2] Univ Med Ctr, Artificial Heart Program, Tucson, AZ USA
关键词
D O I
10.1016/S0003-4975(00)02625-4
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. Device selection has historically been supported by minimal comparative data. Since 1994, we have implanted 43 patients with the CardioWest Total Artificial Heart (CW), 23 with the Novacor Left Ventricular Assist System (N), and 26 with the Thoratec Ventricular Assist System (T). This experience provides a basis for our device selection criteria. Methods. We reviewed retrospectively the results for survival, stroke, and infection in the CW, N, and T groups. Statistical methods included the Student's t-test, x(2) analysis, and Kaplan-Meier actuarial survival curves. Results. The T group patients were younger and smaller sized than the CW or N group. The CW group had the highest mean central venous pressure (CVP) and lowest mean cardiac index. Survival to transplantation was 75% for CW, 57% for N, and 38% for T. Multiple organ failure postimplant caused most deaths in the CW and T groups. Right heart failure and stroke caused most N deaths. Linearized stroke rates (event/patient-month) were 0.03 for CW, 0.28 for N, and 0.08 for T. Serious infections were found in 20% of CW, 30% of N, and 8% of T patients, but linearized rates showed little difference and death from infection was rare. Conclusions. The N device should be used in "stable" patients with body surface area (BSA) greater than 1.7 m(2) and with minimal right heart failure. Unstable patients with biventricular failure should receive a CW if the BSA is greater than 1.7 m(2) or a T if they are smaller. (C) 2001 by The Society of Thoracic Surgeons.
引用
收藏
页码:S92 / S97
页数:6
相关论文
共 21 条
[1]   Biventricular cannulation for the Thoratec ventricular assist device [J].
Arabía, FA ;
Paramesh, V ;
Toporoff, B ;
Arzouman, DA ;
Sethi, GK ;
Copeland, JG .
ANNALS OF THORACIC SURGERY, 1998, 66 (06) :2119-2120
[2]   Implantation technique for the CardioWest total artificial heart [J].
Arabia, FA ;
Copeland, JG ;
Pavie, A ;
Smith, RG .
ANNALS OF THORACIC SURGERY, 1999, 68 (02) :698-704
[3]  
ARABIA FA, 1999, ADV THERAPY CARDIAC, P416
[4]  
Arabia Francisco A., 1993, P693
[5]  
Argenziano M, 1997, J HEART LUNG TRANSPL, V16, P822
[6]  
COPELAND JG, 1986, JAMA-J AM MED ASSOC, V256, P2991
[7]   Bridge to transplantation: Selection and timing [J].
Copeland, JG .
TRANSPLANTATION PROCEEDINGS, 2000, 32 (07) :1535-1536
[8]   SELECTION OF PATIENTS FOR CARDIAC TRANSPLANTATION [J].
COPELAND, JG ;
EMERY, RW ;
LEVINSON, MM ;
ICENOGLE, TB ;
CARRIER, M ;
OTT, RA ;
COPELAND, JA ;
MCALEERRHENMAN, MJ ;
NICHOLSON, SM .
CIRCULATION, 1987, 75 (01) :2-9
[9]  
Copeland JG, 1996, J HEART LUNG TRANSPL, V15, P94
[10]   Arizona experience with CardioWest Total Artificial Heart bridge to transplantation [J].
Copeland, JG ;
Arabia, FA ;
Smith, RG ;
Sethi, GK ;
Nolan, PE ;
Banchy, ME .
ANNALS OF THORACIC SURGERY, 1999, 68 (02) :756-760