Short-term bridge to heart transplant using the BVS 5000 external ventricular assist device.
From January 1995 to April 2001, 71 patients with cardiogenic shock using the BVS 5000 were treated or accepted in transfer. Of the 24 transplanted, nine had dilated cardiomyopathy, ischemic cardiomyopathy, acute myocardial infarction, giant cell myocarditis and previous Fontan procedure (group I, n = 13). The others had postcardiotomy shock (group II, n = 11); seven were transferred to our center after device implantation. Age ranged from 8 to 67 years. Ten (77%) patients in group I were implanted without cardiopulmonary bypass. The mean duration of support was 6.7 (2-24) d. Twelve patients were extubated before transplantation and 13 (five in group I, eight in group II) received nonstandard donor organs. Survival to discharge and 1-year actuarial survival was 85 and 77% for group I and 73 and 64% for group II, respectively. Patients with post-implant serum bilirubin levels > 10 mg/dL had a tendency to expire from multiple systemic organ failure. Patients not ventilator-dependent at the time of transplant had the best outcomes. Short-term bridge to transplantation using the BVS 5000 is feasible in selected patients. Caution is recommended when directing such patients to transplant if they need ventilator support and have high serum bilirubin levels.
Tsai
Feng-Chun
FC
University of California, Los Angeles, Heart Transplant Program, UCLA School of Medicine, 90095-1741, USA.
Marelli
Daniel
D
Laks
Hillel
H
Moriguchi
Jaime
J
Sopher
Michael
M
Bresson
Jessica
J
Moghaddam
Saleh
S
Kubak
Barnard
B
Esmailian
Fardad
F
Ardehali
Abbas
A
Plunkett
Mark
M
Litwin
Paul
P
Kobashigawa
Jon
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D001835:Body Weight; D002315:Cardiopulmonary Bypass; D002648:Child; D005500:Follow-Up Studies; D016027:Heart Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D006353:Heart-Assist Devices; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D016276:Ventricular Function / Q000502:physiology*