Role of the Abiomed BVS 5000 device for short-term support and bridge to transplantation.
Over the last 10 years, we have gained experience implanting the Abiomed BVS 5000 (Abiomed, Inc., Danvers, MA) device for short-term mechanical support. We retrospectively reviewed our experience with this device. From April 1993 through January 2003, 71 patients underwent implantation of an Abiomed BVS 5000 device. This included 19 left ventricular assist devices (LVADs), 30 right ventricular assist devices (RVADs), and 22 biventricular assist devices (BIVADs). Demographics of device recipients, conditions for mechanical support, and outcome were evaluated for each device type. Devices were inserted for postcardiotomy cardiogenic shock in 53 (74.6%) patients and precardiotomy cardiogenic shock in 18 (25.4%) patients. Mean duration of support was 4.9+/-4.1 days, with 64 (90.1 %) patients supported for fewer than 10 days. Twenty-nine (40.8%) patients were successfully weaned from support after myocardial recovery: 7 (36.8%) LVADs, 13 (43.3%) RVADs, and 9 (40.9%) BIVADs. Eight (11.3%) patients received devices as a "bridge to bridge," undergoing implantation of a long-term HeartMate LVAD (Thoratec, Pleasanton, CA): six (31.6%) LVADs and two (9.1 %) BIVADs. Seven (9.9%) Abiomed patients were successfully bridged to transplantation: two (10.5%) LVADs, two (6.7%) RVADs, and three (13.6%) BIVADs. Overall, 44 (62.0%) patients survived support: weaned, "bridged to bridge," or transplanted. The Abiomed BVS 5000 can be used effectively for short-term stabilization and for bridging to transplant in select patients.
Department of Surgery, Division of Cardiothoracic Surgery, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Jeffrey A
JA
Morgan
Allan S
AS
Stewart
Brian J
BJ
Lee
Mehmet C
MC
Oz
Yoshifumi
Y
Naka
D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D002423:Cause of Death; D005260:Female; D006331:Heart Diseases / Q000601:surgery*; D016027:Heart Transplantation; D006353:Heart-Assist Devices / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012189:Retrospective Studies; D012770:Shock, Cardiogenic / Q000209:etiology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome