title: Extracorporeal membrane oxygenation and Thoratec pneumatic ventricular assist devices as double bridge to heart transplantation.
abstract: BACKGROUND
  Ventricular assist devices have benefited patients with end-stage heart failure as a bridge to heart transplantation (HTx). We present our experiment of HTx using extracorporeal membrane oxygenation (ECMO) with Thoratec pneumatic ventricular assist device (TpVAD).
  
  
  METHODS
  From May 1996 to June 2011, among 410 patients who underwent HTx 23 required mechanical circulatory support (MCS) with implantation of the TpVAD and 15 (65%) of them received grafts.
  
  
  RESULTS
  The 23 patients included 4 female and 19 male patients of age range 10 to 80 years. Eighteen (78%) of them needed ECMO before TpVAD implantation. Twelve (67%) were implanted with a TpVAD double bridge to HTx. The demand for MCS among patients with acute hemodynamic collapse has led to major improvements in the existing systems such as ECMO with double bridge to TpVAD.
  
  
  CONCLUSIONS
  We used ECMO as a rescue procedure for acute hemodynamic deterioration. However, during ECMO support, left ventricular afterload increased. If prolonged support is required, TpVAD might be required: 15 (65%) of patients supported by ECMO with TpVAD needed to a wait a suitable donor. We recommend the application of ECMO for short-term support (within 1 week), and TpVAD as a bridge for medium- or long-term support.
authors.affiliation: Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: N-K
authors.initials: NK
authors.lastname: Chou
authors.forename: J-M
authors.initials: JM
authors.lastname: Luo
authors.forename: N-H
authors.initials: NH
authors.lastname: Chi
authors.forename: I-H
authors.initials: IH
authors.lastname: Wu
authors.forename: S-C
authors.initials: SC
authors.lastname: Huang
authors.forename: Y-S
authors.initials: YS
authors.lastname: Chen
authors.forename: H-Y
authors.initials: HY
authors.lastname: Yu
authors.forename: C-I
authors.initials: CI
authors.lastname: Tsao
authors.forename: W-J
authors.initials: WJ
authors.lastname: Ko
authors.forename: S-H
authors.initials: SH
authors.lastname: Chu
authors.forename: S-S
authors.initials: SS
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006333:Heart Failure / Q000401:mortality / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D016027:Heart Transplantation / Q000009:adverse effects / Q000401:mortality; D006353:Heart-Assist Devices / Q000009:adverse effects; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D013624:Taiwan; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D014850:Waiting Lists; D055815:Young Adult