Characteristics and outcomes of patients bridged to cardiac transplantation on centrifugal ventricular assist devices: a case series of the early experience of one Canadian transplant centre.
BACKGROUND
Centrifugal ventricular assist devices (VADs) have been used successfully to bridge patients in cardiogenic shock to cardiac transplantation, though complications are frequent and often life-threatening.


OBJECTIVE
To describe characteristics and examine outcomes of patients bridged to cardiac transplantation on centrifugal VADs.


METHODS
A retrospective health record review was conducted on all adults over a 12 year period (N=20) placed on centrifugal VADs with the intent to bridge to cardiac transplantation at a major Canadian transplant centre.


RESULTS
Complications of VAD support necessitated removal of 12 patients from the transplant list; seven (35%) survived to cardiac transplantation. Of the seven recipients, five survived to discharge and four remain alive and well.


CONCLUSIONS
Bridging patients on centrifugal VADs to cardiac transplantation requires improvement, including maintaining patient stability during the period of early VAD institution, aggressively managing complications of VAD support, and consideration of long-term pulsatile devices. However, if patients survive to transplantation, good long-term outcomes are expected.
Scherr
Kimberly
K
Division of Cardiothoracic Surgery, University of Alberta Hospital, 3A2.34 Walter Mackenzie Centre, 8440-112th Street, Edmonton, AB, Canada T6G 2B7.
Jensen
Louise
L
Koshal
Arvind
A
D000328:Adult; D000416:Alberta / Q000453:epidemiology; D002423:Cause of Death; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology / Q000209:etiology; D006304:Health Status; D016027:Heart Transplantation / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data*; D006353:Heart-Assist Devices / Q000009:adverse effects / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D018579:Patient Selection; D011300:Preoperative Care / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012770:Shock, Cardiogenic / Q000209:etiology / Q000401:mortality / Q000628:therapy; D016019:Survival Analysis; D016896:Treatment Outcome; D014850:Waiting Lists