title: Clinical experience with HeartWare left ventricular assist device in patients with end-stage heart failure.
abstract: BACKGROUND
  The gold standard treatment for end-stage heart failure is cardiac transplantation. Because of the increasing number of heart failure patients and the limited supply of donor hearts, a ventricular assist device (VAD) is used as a bridge to transplantation, recovery, or decision. Newer generation VADs have lower risk of fatal adverse events and are also smaller in size. We present our experience with the intrapericardial HeartWare VAD (HeartWare, Framingham, MA) and its clinical outcome.
  
  
  METHODS
  The clinical outcome of HeartWare VAD implantations for end-stage heart failure patients performed at Harefield Hospital from March 2007 to June 2011 was studied. The study design was a retrospective review of the prospectively collected data.
  
  
  RESULTS
  Thirty-four patients with a mean age of 51±10 years were included in this study. Twenty-nine patients were male (85%). The mean duration of mechanical support was 261±64 days. Five patients (15%) were successfully bridged to heart transplantation. The overall mortality was 24% (8 patients). There were 1 case of mechanical device failure (2%) and 3 cases of device failure due to thrombus formation (8%). Postoperative complications included 5 reoperations for bleeding (15%), 12 acute renal failures (36%), 7 respiratory failures (21%), 2 hepatic dysfunctions (6%), 3 neurologic dysfunctions (9%), 7 right-side heart failures (21%), and 5 driveline infections (15%).
  
  
  CONCLUSIONS
  Although cardiac transplantation remains the gold standard for treatment of end-stage heart failure patients, the HeartWare VAD can be used as a safe alternative with a satisfactory clinical outcome.
authors.affiliation: Department of Cardiothoracic Surgery and Transplantation, Harefield Hospital, Harefield, United Kingdom. a.popov@rbht.nhs.uk
authors.forename: Aron Frederik
authors.initials: AF
authors.lastname: Popov
authors.forename: Morteza Tavakkoli
authors.initials: MT
authors.lastname: Hosseini
authors.forename: Bartlomiej
authors.initials: B
authors.lastname: Zych
authors.forename: Prashant
authors.initials: P
authors.lastname: Mohite
authors.forename: Rachel
authors.initials: R
authors.lastname: Hards
authors.forename: Heike
authors.initials: H
authors.lastname: Krueger
authors.forename: Toufan
authors.initials: T
authors.lastname: Bahrami
authors.forename: Mohamed
authors.initials: M
authors.lastname: Amrani
authors.forename: Andre Ruediger
authors.initials: AR
authors.lastname: Simon
mesh_terms: D000328:Adult; D005260:Female; D006333:Heart Failure / Q000601:surgery*; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult