A prospective, multicenter trial of the VentrAssist left ventricular assist device for bridge to transplant: safety and efficacy.
BACKGROUND
The increasing prevalence of chronic heart failure has stimulated the ongoing development of left ventricular assist devices (LVADs) for both bridge-to-transplant (BTT) and destination therapy (DT). The aim of this prospective, multicenter clinical trial was to determine the efficacy and safety of a third-generation LVAD, the VentrAssist, in a BTT cohort.


METHODS
Patients (n = 33) with end-stage chronic heart failure who required circulatory support as BTT therapy were implanted with a VentrAssist device. The primary outcome was survival until transplant or transplant eligibility with the device in situ at trial end-point (Day 154 after implant). The secondary outcomes were pump flow index and end-organ function. Safety, patient functional status and resource use were also assessed.


RESULTS
At trial end-point, the success rate was 82% (39.4% transplanted, 42.4% transplant-eligible). The LVAD pump flow index (median >or=2.7 liters/min/m(2)) was sufficient to maintain an adequate circulation and significantly improve end-organ function. Of the 77 protocol-defined serious adverse events, most occurred within 30 days of implantation. No patients died as a direct result of pump failure or malfunction. After implantation, patient functional status improved, with 70% of patients achieving hospital discharge, and resource use was reduced.


CONCLUSIONS
This trial demonstrated a favorable efficacy and safety profile for use of the VentrAssist LVAD in BTT patients.
Esmore
Donald
D
The Alfred Hospital, Melbourne, Australia.
Kaye
David
D
Spratt
Phillip
P
Larbalestier
Robert
R
Ruygrok
Peter
P
Tsui
Steven
S
Meyers
Deborah
D
Fiane
Arnt E
AE
Woodard
John
J
D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000601:surgery*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*