title: First clinical experience with the DeBakey VAD continuous-axial-flow pump for bridge to transplantation.
abstract: BACKGROUND
  A shortage of donor organs and increased numbers of deaths of patients on the waiting list for cardiac transplantation make mechanical circulatory support for a bridge to transplantation a standard clinical procedure. Continuous-flow rotary blood pumps offer exciting new perspectives.
  
  
  RESULTS
  Two male patients (ages 44 and 65 years) suffering from end-stage left heart failure were implanted with a DeBakey VAD axial-flow pump for use as a bridge to transplant. In the initial postoperative period, the mean pump flow was 3.9+/-0.5 L/min, which equals a mean cardiac index (CI) of 2.3+/-0.2 L. min(-1). m(-2). In both patients, the early postoperative phase was characterized by a completely nonpulsatile flow profile. However, with the recovery of heart function 8 to 12 days after implantation, increasing pulse pressures became evident, and net flow rose to 4.5+/-0.6 L/min, causing an increase of mean CI up to 2.7+/-0.2 L. min(-1). m(-2). Patients were mobilized and put through regular physical training. Hemolysis stayed in the physiological range and increased only slightly from 2. 1+/-0.8 mg/dL before surgery to 3.3+/-1.8 mg/dL 6 weeks after implantation.
  
  
  CONCLUSIONS
  The first clinical implants of the DeBakey VAD axial-flow pump have demonstrated the device to be a promising measure of bridge-to-transplant mechanical support.
authors.affiliation: Department of Cardiothoracic Surgery, University of Vienna, Austria. georg.wieselthaler@akh-wien.ac.at
authors.forename: G M
authors.initials: GM
authors.lastname: Wieselthaler
authors.forename: H
authors.initials: H
authors.lastname: Schima
authors.forename: M
authors.initials: M
authors.lastname: Hiesmayr
authors.forename: R
authors.initials: R
authors.lastname: Pacher
authors.forename: G
authors.initials: G
authors.lastname: Laufer
authors.forename: G P
authors.initials: GP
authors.lastname: Noon
authors.forename: M
authors.initials: M
authors.lastname: DeBakey
authors.forename: E
authors.initials: E
authors.lastname: Wolner
mesh_terms: D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000628:therapy*; D004867:Equipment Design; D006333:Heart Failure / Q000628:therapy*; D016027:Heart Transplantation; D006353:Heart-Assist Devices / Q000009:adverse effects; D006461:Hemolysis; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000150:complications* / Q000628:therapy; D014019:Tissue Donors / Q000600:supply & distribution