Univentricular versus biventricular assist device support.
Controversy continues over whether patients should receive selective univentricular assist devices (UVADs) or biventricular assist devices (BVADs). Data from 39 patients supported for more than 2 days with Thoratec VADs were analyzed to compare mortality and morbidity between those receiving UVAD versus BVAD. Twenty-three patients received UVADs and 16 BVADs. Age, gender, and duration of support did not differ significantly between the two groups. Morbidity in VAD patients does not differ between UVAD and BVAD support. Survival is determined by the reversibility of pre-VAD myocardial damage or the eligibility for transplantation, rather than by the number of devices used. These data do not support the use of BVAD in all patients; they support a selective approach based on hemodynamic requirements.
Pennington
D G
DG
Department of Surgery, St. Louis University Medical Center, Mo 63110-0250.
Reedy
J E
JE
Swartz
M T
MT
McBride
L R
LR
Seacord
L M
LM
Naunheim
K S
KS
Miller
L W
LW
D006348:Cardiac Surgical Procedures; D004867:Equipment Design; D005260:Female; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy; D011183:Postoperative Complications / Q000401:mortality / Q000628:therapy; D012770:Shock, Cardiogenic / Q000401:mortality / Q000628:therapy*