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Emergency use of wearable left ventricular assist devices in patients not eligible for heart transplantation.

Abstract：

BACKGROUND:We reviewed our experience concerning the clinical outcomes of emergency implantation of left ventricular assist devices (LVAD) in patients not eligible for heart transplantation (HTX). PATIENTS AND METHODS:Between January 1998 and September 2006, 62 patients were referred for emergency HTX including 35 (55%) who received cardiac allografts; 9 (14%) died on the waiting list. The other 18 subjects (31%) did not meet listing criteria due to pulmonary hypertension with massive transpulmonary gradients (TPG), severe diabetes, or another factor; 7 patients had wearable LVAD implants and the remaining 11 who had contraindications both to HTX and to LVAD implantation remained on medical therapy. RESULTS:Twelve month actuarial survivals were 47% in LVAD G1 vs 1% in medical therapy G2 (P< .005). Four G1 patients died either due to cerebrovascular vascular episodes or to thromboembolic events. The beneficial use of LVAD in 3 patients led to consistent improvement in hemodynamic performance allowing listing for HTX. Two of them have been successfully transplanted; 1 is still waiting. Due to refractory heart failure, 90% of G2 died within the first months after evaluation. CONCLUSION:Our limited experience indicated that emergency use of LVAD ensued a satisfactory outcome allowing better actuarial survival.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Forni A,Faggian G,Chiominto B,Innocente F,Ferrara A,Iafrancesco M,Mazzucco A

doi

10.1016/j.transproceed.2008.05.073

subject

Has Abstract

pub_date

2008-07-01 00:00:00

pages

1993-5

issue

6

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(08)00730-6

journal_volume

40

pub_type

杂志文章

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