title: Left ventricular assist device therapy improves utilization of donor hearts.
abstract: OBJECTIVE
  We sought to determine the survival experiences of patients bridged to heart transplantation with either intravenous (IV) inotropes or an implantable left ventricular assist device (LVAD).
  
  
  BACKGROUND
  Because of the operative risks of LVAD implantation and the reported lower mortality associated with inotropic therapy, bridging to heart transplantation with inotropes is thought to be the preferred treatment option.
  
  
  METHODS
  Between April 1, 1996, and May 10, 2001, a total of 104 patients were bridged to heart transplantation with either IV inotropes (n = 38) or an implantable LVAD (n = 66; HeartMate). Survival was compared (Kaplan-Meier method) for three periods: survival to transplantation, post-transplantation survival and overall survival (i.e., survival from the onset of bridging to follow-up).
  
  
  RESULTS
  Survival to transplantation was 81 +/- 5% at three months for the LVAD group and 64 +/- 11% for the inotrope group (p = NS). Post-transplantation survival was 95 +/- 4% at three years for the LVAD group (two deaths) and 65 +/- 10% at three years for the inotrope group (nine deaths; p = 0.007). Overall survival was 77 +/- 6% at three years for the LVAD group and 44 +/- 9% at three years for the inotrope group (p = 0.01).
  
  
  CONCLUSIONS
  Overall survival for patients who were bridged to heart transplantation with an implantable LVAD was superior to that of patients who were bridged with inotropes. Bridging to transplantation with an implantable LVAD improves utilization of donor hearts.
authors.affiliation: Division of Cardiology, University of Michigan, Ann Arbor, Michigan 48109, USA.
authors.forename: Keith D
authors.initials: KD
authors.lastname: Aaronson
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Eppinger
authors.forename: David B
authors.initials: DB
authors.lastname: Dyke
authors.forename: Susan
authors.initials: S
authors.lastname: Wright
authors.forename: Francis D
authors.initials: FD
authors.lastname: Pagani
mesh_terms: D000293:Adolescent; D000328:Adult; D002316:Cardiotonic Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D013504:Cardiovascular Surgical Procedures / Q000295:instrumentation; D004869:Equipment Safety; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation; D006352:Heart Ventricles / Q000601:surgery*; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D002316:Cardiotonic Agents