Improved survival in patients with ventricular assist device therapy: the University of Wisconsin experience.

摘要: Objective: Ventricularassistdevices(VADs)have beenimplantedsince 1990inour institution,becomingan increasinglycommontreatmentfor end-stage heart failure. Beginning in 1997, VAD patients were discharged home when feasible. In August 2003, a dedicated multidisciplinary team (cardiac surgeons, cardiologists, coordinators, nurses, rehabilitation specialists, nutrition experts, psychologists, pharmacists, social workers,andadministrators)wascreatedto optimizethemanagement ofVADpatients.Thepurposeofthisstudyis toanalyzethe impactofthese changes care at our center over the last 17 years. Methods: We retrospectively studied 107 consecutive recipients between June 1990 and 2006. VADs implanted as bridge to recovery, transplant destination therapy. The cohort was divided by plans into early (n = 37, 1990—1996), mid 32, 1997—July 2003), late groups 38, 2003—August 2006). Demographic profile, survival complications assessed. Results: Patient demographics tended show an increased severity of illness time. Post-VAD rate significantly improved group (post-VAD 1- 3-year rates; early: 54.1% 40.5%; mid: 51.6% 41.9%; late: 86.8% 82.5%, p < 0.001, respectively). incidence including re-operation, major bleeding infection, decreased (p 0.05). Conclusions: Outcomes have dramatically recent patients, despite increasingly highrisk patient population. These data suggest that advances device technology medical therapies, well approach, on # 2008 European Association for Cardio-Thoracic Surgery. Published Elsevier B.V. All rights reserved.