Comparison of results after heart transplantation: mechanically supported versus nonsupported patients.
Between March 1984 and July 1990 our team transplanted 168 hearts. One hundred twelve patients did not require mechanical support (group I). Fifty-six patients required mechanical support (group II). Intraaortic balloon counterpulsation was used in 37 patients (66%). The total artificial heart (TAH) was used in 16 patients (29%), and the ventricular assist device (VAD) was used in three patients (5%). The time spent on the device ranged from 1 to 35 days. No statistical difference was noted on the survival between the two groups. The 30-day and 1-year survival rate was 95% (106 patients) and 71% (79 patients) in group I and 91% (51 patients) and 68% (38 patients) in group II. As of July 31, 1990, 70% in group I and 68% in group II are alive. No significant differences were found between the two groups for the following variables (after heart transplantation): length of stay, 30-day survival, 1-year survival, and complications. The only significant difference found between the two groups was the incidence of infections: group I, 23%; group II, 51.7% (p = 0.001). Mechanical support as a bridge to transplantation provides excellent support until a donor becomes available. No difference was found in the 30-day and 1-year survival between the two groups.
Pifarre
R
R
Department of Thoracic and Cardiovascular Surgery, Loyola University Medical Center, Maywood, Ill. 60153.
Sullivan
H
H
Montoya
A
A
Bakhos
M
M
Grieco
J
J
Foy
B K
BK
Blakeman
B
B
Costanzo-Nordin
M R
MR
Altergott
R
R
Lonchyna
V
V
D002423:Cause of Death; D005260:Female; D016027:Heart Transplantation / Q000401:mortality*; D006354:Heart, Artificial; D006353:Heart-Assist Devices; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007423:Intra-Aortic Balloon Pumping; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011300:Preoperative Care; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors
D007166:Immunosuppressive Agents