Clinical outcome and bridge to transplant rate of left ventricular assist device recipient patients: comparison between continuous-flow and pulsatile-flow devices

Background: Long-term implantable continuous axial-flow pumps are increasingly used in bridging heart failure patients to heart transplant. Compared to pulsatile left ventricular assist devices (LVADs), they offer smaller dimensions, less surgical trauma and less thromboembolisms. However concerns s...

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Bibliographic Details
Published in:European journal of cardio-thoracic surgery 2008-08, Vol.34 (2), p.275-280
Main Authors: Garatti, Andrea, Bruschi, Giuseppe, Colombo, Tiziano, Russo, Claudio, Lanfranconi, Marco, Milazzo, Filippo, Frigerio, Maria, Vitali, Ettore
Format: Article
Language:English
Subjects:
Adult
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Cardiology. Vascular system
Chronic Disease
Chronic post-transplant rejection
Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care
Epidemiologic Methods
Female
Graft Rejection
Heart Failure - therapy
Heart Transplantation
Heart-Assist Devices - adverse effects
Humans
Intensive care medicine
Left ventricular assist devices
Male
Medical sciences
Middle Aged
Multi-organ failure syndrome
Pneumology
Prosthesis Design
Pulsatile Flow
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the heart
Treatment Outcome
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Summary:Background: Long-term implantable continuous axial-flow pumps are increasingly used in bridging heart failure patients to heart transplant. Compared to pulsatile left ventricular assist devices (LVADs), they offer smaller dimensions, less surgical trauma and less thromboembolisms. However concerns still remain about the long-term effects of continuous-flow on patients’ outcome. The aim of this study was to review our mechanical bridge to transplant experience to compare pre- and post-transplant outcomes between pulsatile and continuous-flow LVAD recipients. Methods: Thirty-six patients with a continuous-flow device (Micromed DeBakey, Houston, TX or InCor Berlin Heart, Berlin, Germany – group A) were compared with 41 patients supported with a pulsatile device (Novacor®, WorldHeart, Oakland, CA – group B). Results: Mean age (48.6 ± 12.4 vs 47.2 ± 12.5) and LVAD duration (119.3 ± 115.4 vs 128.3 ± 198.3) were similar in the two groups. Group A recipients were smaller compared to group B (mean body surface area = 1.77 ± 0.18 vs 1.93 ± 0.16; p 
ISSN:1010-7940
1873-734X
DOI:10.1016/j.ejcts.2008.02.019