First clinical experience with the DeBakey VAD continuous-axial-flow pump for bridge to transplantation

• Published in: Circulation (New York, N.Y.) N.Y.), 2000-02, Vol.101 (4), p.356-359
• Main Authors: WIESELTHALER, G. M, SCHIMA, H, HIESMAYR, M, PACHER, R, LAUFER, G, NOON, G. P, DEBAKEY, M, WOLNER, E
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Cardiology. Vascular system; Cardiomyopathy, Dilated - complications; Cardiomyopathy, Dilated - therapy; Equipment Design; Heart; Heart Failure - therapy; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Heart Transplantation; Heart-Assist Devices - adverse effects; Hemolysis; Humans; Male; Medical sciences; Myocardial Ischemia - complications; Myocardial Ischemia - therapy; Tissue Donors - supply & distribution
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/01.CIR.101.4.356

A shortage of donor organs and increased numbers of deaths of patients on the waiting list for cardiac transplantation make mechanical circulatory support for a bridge to transplantation a standard clinical procedure. Continuous-flow rotary blood pumps offer exciting new perspectives. Two male patients (ages 44 and 65 years) suffering from end-stage left heart failure were implanted with a DeBakey VAD axial-flow pump for use as a bridge to transplant. In the initial postoperative period, the mean pump flow was 3.9+/-0.5 L/min, which equals a mean cardiac index (CI) of 2.3+/-0.2 L. min(-1). m(-2). In both patients, the early postoperative phase was characterized by a completely nonpulsatile flow profile. However, with the recovery of heart function 8 to 12 days after implantation, increasing pulse pressures became evident, and net flow rose to 4.5+/-0.6 L/min, causing an increase of mean CI up to 2.7+/-0.2 L. min(-1). m(-2). Patients were mobilized and put through regular physical training. Hemolysis stayed in the physiological range and increased only slightly from 2. 1+/-0.8 mg/dL before surgery to 3.3+/-1.8 mg/dL 6 weeks after implantation. The first clinical implants of the DeBakey VAD axial-flow pump have demonstrated the device to be a promising measure of bridge-to-transplant mechanical support.