The European experience of Novacor left ventricular assist (LVAS) therapy as a bridge to transplant: a retrospective multi-centre study.

摘要: Objective: Artificial heart devices have suffered from a negative press based on the early Jarvik experience of 1980s. This is in stark contrast to realities current left ventricular assist (LVAS) therapy. The Novacor N100 PC wearable system was introduced Europe late 1993. allows implanted recipients be completely autonomous with controlled by small computer and powered rechargeable batteries. report represents initial European LVAS. Methods: Since regulatory approval as commercial product, clinicians were not bound constraints study protocol only minimal data collected. presents results retrospective 118 consecutive patients who had LVAS bridge transplant, 19 centres over three year period ending November 1996. Results: Mortality morbidity varied widely between centres. median implant time 115 days (0‐585 days) 33% returned home, supported overall survival 64%. major causes death infection (14%) MOF (6%). There no significant device or failures despite cumulative patient 24.8 years outside hospital environment. Patient selection management greatly this reflected disparate outcomes. Conclusions: Optimal has still established. While available for lacked detail necessary demonstrate direct causal relationships management, it clear inter-centre differences that these two factors impact directed attention towards improved regimes. Given obtained best ability discharge lead near-normal lives community, authors believe now offers real therapeutic alternative selected end-stage failure whom donor unavailable are unsuitable transplantation. q 1999 Elsevier Science B.V. All rights reserved.