HeartMate left ventricular assist device for long-term circulatory support.
We describe three successful cases of HeartMate left ventricular assist device (LVAD; Thermo Cardiosystems, Woburn, MA, USA) implantation in patients with end-stage heart failure for long-term circulatory support. Patient 1 was a 34-year-old woman with postpartum cardiomyopathy. Patients 2 and 3 were both males with dilated cardiomyopathy, 50 years and 21 years of age, respectively. They all presented in cardiogenic shock with decreased sensorium and anuria. Temporary mechanical support with an intra-aortic balloon pump or extracorporeal membrane oxygenation (ECMO) was needed for life support. Because bleeding and right ventricular failure often occur after HeartMate LVAD implantation, we used a Vascutek tube (Vascutek Ltd, Inchinnan, Scotland) graft to wrap inflow and outflow valve conduits and ECMO as a bridge to HeartMate LVAD implantation. Following surgery, cardiac output increased from 2.70, 2.06 and 2.53 L/min to 4.50, 5.80 and 5.00 L/min in the three patients. HeartMate LVAD can provide safe and stable long-term circulatory support without the need for anticoagulation. One of the patients remained on HeartMate for 287 days before undergoing successful heart transplantation. Patients with HeartMate LVAD are ambulatory and may be discharged while awaiting heart transplantation. Heart function may recover after long-term ventricular unloading with HeartMate LVAD.
Hsu
R B
RB
Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
Chu
S H
SH
Chien
C Y
CY
Ko
W J
WJ
Chou
N K
NK
Chen
Y S
YS
Wang
S S
SS
D000328:Adult; D009202:Cardiomyopathies / Q000628:therapy; D005260:Female; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged