Skip to main content
PMC home page
Netherlands Heart Journal logoLink to Netherlands Heart Journal
. 2002 Jun;10(6):267–271.

Left ventricular assist device as bridge to transplantation in patients with end-stage heart failure

Eight-year experience with the implantable HeartMate LVAS

JR Lahpor, N de Jonge, HA van Swieten, H Wesenhagen, C Klöpping, JH Geertman, A Oosterom, B Rodermans, JH Kirkels
PMCID: PMC2499769  PMID: 25696107

Abstract

Objective

To evaluate the use of left ventricular assist devices (LVAD) as bridge to heart transplantation (HTx) in patients with end-stage heart failure.

Method

Between March 1993 and December 2001, 38 patients with refractory end-stage heart failure underwent HeartMate LVAD (Thoratec, Pleasanton Calif.) implantation.

Results

A total of 33 of the 38 patients (87%) survived the implantation and perioperative period. There were five perioperative deaths (13%), two due to right ventricular failure, two as a result of bleeding and one probably due to septic shock at the time of LVAD implantation. Three patients (9%) died late in the postoperative period due to septic shock, mechanical failure of the device and a cerebral embolus resulting from LVAD endocarditis, initiated by an acute cholecystitis. Twelve patients (32%) had one or more infectious episodes during long-term assist, of which one patient died. Four patients are still on the device, waiting for a heart transplantation. Twenty-six patients (76%) underwent HTx after 206±129 days of support.

Conclusion

These results show the efficacy of LVAD support as a bridge to heart transplantation in patients with end-stage heart failure. Major long-term complications are infections and mechanical failure of the device.

Keywords: heart failure, heart transplantation, left ventricular assist devices

Full text

PDF
271

Images in this article

268Figure 1
on p.268
268Figure 2
on p.268

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bradbury J., McCarthy M. Perinatal HIV-1 transmission discussed in Geneva. Lancet. 1998 Jul 4;352(9121):39–39. doi: 10.1016/S0140-6736(98)23027-3. [DOI] [PubMed] [Google Scholar]
  2. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. The SOLVD Investigators. N Engl J Med. 1991 Aug 1;325(5):293–302. doi: 10.1056/NEJM199108013250501. [DOI] [PubMed] [Google Scholar]
  3. El-Banayosy A., Arusoglu L., Kizner L., Tenderich G., Minami K., Inoue K., Körfer R. Novacor left ventricular assist system versus Heartmate vented electric left ventricular assist system as a long-term mechanical circulatory support device in bridging patients: a prospective study. J Thorac Cardiovasc Surg. 2000 Mar;119(3):581–587. doi: 10.1016/s0022-5223(00)70140-1. [DOI] [PubMed] [Google Scholar]
  4. Frazier O. H., Rose E. A., Macmanus Q., Burton N. A., Lefrak E. A., Poirier V. L., Dasse K. A. Multicenter clinical evaluation of the HeartMate 1000 IP left ventricular assist device. Ann Thorac Surg. 1992 Jun;53(6):1080–1090. doi: 10.1016/0003-4975(92)90393-i. [DOI] [PubMed] [Google Scholar]
  5. Fukamachi K., McCarthy P. M., Smedira N. G., Vargo R. L., Starling R. C., Young J. B. Preoperative risk factors for right ventricular failure after implantable left ventricular assist device insertion. Ann Thorac Surg. 1999 Dec;68(6):2181–2184. doi: 10.1016/s0003-4975(99)00753-5. [DOI] [PubMed] [Google Scholar]
  6. Goldstein D. J., Oz M. C., Rose E. A. Implantable left ventricular assist devices. N Engl J Med. 1998 Nov 19;339(21):1522–1533. doi: 10.1056/NEJM199811193392107. [DOI] [PubMed] [Google Scholar]
  7. Holman W. L., Murrah C. P., Ferguson E. R., Bourge R. C., McGiffin D. C., Kirklin J. K. Infections during extended circulatory support: University of Alabama at Birmingham experience 1989 to 1994. Ann Thorac Surg. 1996 Jan;61(1):366–373. doi: 10.1016/0003-4975(95)01021-1. [DOI] [PubMed] [Google Scholar]
  8. Jaski B. E., Lingle R. J., Kim J., Branch K. R., Goldsmith R., Johnson M. R., Lahpor J. R., Icenogle T. B., Piña I., Adamson R. Comparison of functional capacity in patients with end-stage heart failure following implantation of a left ventricular assist device versus heart transplantation: results of the experience with left ventricular assist device with exercise trial. J Heart Lung Transplant. 1999 Nov;18(11):1031–1040. doi: 10.1016/s1053-2498(99)00071-6. [DOI] [PubMed] [Google Scholar]
  9. Koul B., Solem J. O., Steen S., Casimir-Ahn H., Granfeldt H., Lönn U. J. HeartMate left ventricular assist device as bridge to heart transplantation. Ann Thorac Surg. 1998 Jun;65(6):1625–1630. doi: 10.1016/s0003-4975(98)00224-0. [DOI] [PubMed] [Google Scholar]
  10. McCarthy P. M., Smedira N. O., Vargo R. L., Goormastic M., Hobbs R. E., Starling R. C., Young J. B. One hundred patients with the HeartMate left ventricular assist device: evolving concepts and technology. J Thorac Cardiovasc Surg. 1998 Apr;115(4):904–912. doi: 10.1016/S0022-5223(98)70373-3. [DOI] [PubMed] [Google Scholar]
  11. Prendergast T. W., Todd B. A., Beyer A. J., 3rd, Furukawa S., Eisen H. J., Addonizio V. P., Browne B. J., Jeevanandam V. Management of left ventricular assist device infection with heart transplantation. Ann Thorac Surg. 1997 Jul;64(1):142–147. doi: 10.1016/s0003-4975(97)00286-5. [DOI] [PubMed] [Google Scholar]
  12. Rose E. A., Gelijns A. C., Moskowitz A. J., Heitjan D. F., Stevenson L. W., Dembitsky W., Long J. W., Ascheim D. D., Tierney A. R., Levitan R. G. Long-term use of a left ventricular assist device for end-stage heart failure. N Engl J Med. 2001 Nov 15;345(20):1435–1443. doi: 10.1056/NEJMoa012175. [DOI] [PubMed] [Google Scholar]
  13. Sun B. C., Catanese K. A., Spanier T. B., Flannery M. R., Gardocki M. T., Marcus L. S., Levin H. R., Rose E. A., Oz M. C. 100 long-term implantable left ventricular assist devices: the Columbia Presbyterian interim experience. Ann Thorac Surg. 1999 Aug;68(2):688–694. doi: 10.1016/s0003-4975(99)00539-1. [DOI] [PubMed] [Google Scholar]
  14. de Jonge N., Kirkels H., Lahpor J. R., Klöpping C., Hulzebos E. J., de la Rivière A. B., Robles de Medina E. O. Exercise performance in patients with end-stage heart failure after implantation of a left ventricular assist device and after heart transplantation: an outlook for permanent assisting? J Am Coll Cardiol. 2001 Jun 1;37(7):1794–1799. doi: 10.1016/s0735-1097(01)01268-2. [DOI] [PubMed] [Google Scholar]

Articles from Netherlands Heart Journal are provided here courtesy of Springer

RESOURCES