Success rates of long-term circulatory assist devices used currently for bridge to heart transplantation

被引:43
作者
Arabia, FA
Smith, RG
Rose, DS
Arzouman, DA
Sethi, GK
Copeland, JG
机构
[1] University of Arizona, Health Sciences Center, Cardiothoracic Surgery, Tucson, AZ
[2] University of Arizona, Health Sciences Center, Cardiothoracic Surgery, Tucson, AZ 85724
关键词
D O I
10.1097/00002480-199609000-00045
中图分类号
R318 [生物医学工程];
学科分类号
0831 ;
摘要
Circulatory assist devices as bridge to heart transplantation have become more important as the number of possible recipients has increased and the number of donors remains stable. The number of patients successfully bridged and discharged home after transplantation was determined for the Novacor Left Ventricular Assist System (Baxter Healthcare Corp., Oakland, CA) (LVAS), console and wearable; the TCl Left Ventricular Assist Device (Thermo Cardio Systems Inc., Woburn, MA) (LVAD), pneumatic and electric; the Thoratec LVAD and Biventricular Assist Device (Thoratec Lab Co., Berkeley, CA) (BIVAD); and the CardioWest total artificial heart (CardioWest Tech. Inc., Tuscon, AZ) (TAH). A total of 1,286 devices (14% Novacor console, 14% Novacor wearable, 35% TCl pneumatic, 4% TCl electric, 10% Thoratec LVAD, 19% Thoratec BIVAD, and 4% CardioWest TAH) were implanted worldwide since 1984. A total of 776 (60%) patients reached heart transplantation and 687 patients (88.5% of those transplanted) were discharged home. The individual success rate for each device to bridge a patient to heart transplantation and be discharged home is as follows: Novacor LVAS console, 90%; Novacor LVAS wearable, 92%; TCl LVAD pneumatic, 89%; TCl LVAD electric, 89%; Thoratec LVAD, 93%; Thoratec BIVAD, 81%; and CardioWest TAH, 92%. The success rate with all the available systems to bridge a patient to heart transplantation and be discharged home is similar for all devices. The criteria used to determine which system to be used should be individualized for each patient. Some of the factors that should be considered in making a decision on which device to use should include anticoagulation, univentricular vs biventricular failure, mobility, protocol to discharge home, and size of the patient.
引用
收藏
页码:M542 / M546
页数:5
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