Extended mechanical circulatory support with a continuous-flow rotary left ventricular assist device.

摘要: Objectives This study sought to evaluate the use of a continuous-flow rotary left ventricular assist device (LVAD) as bridge heart transplantation. Background LVAD therapy is an established treatment modality for patients with advanced failure. Pulsatile LVADs have limitations in design precluding their extended support. Continuous-flow represent innovative potential small size and greater reliability by simplification pumping mechanism. Methods In prospective, multicenter study, 281 urgently listed (United Network Organ Sharing status 1A or 1B) transplantation underwent implantation LVAD. Survival rates were assessed at 18 months. Patients adverse events throughout quality life, functional status, organ function 6 Results Of patients, 222 (79%) transplantation, removal cardiac recovery, had ongoing support 18-month follow-up. Actuarial survival on was 72% (95% confidence interval: 65% 79%) At months, there significant improvements 6-min walk test (from 0% 83% New York Heart Association class I II from 13% 89% completing test) life (mean values improved 41% Minnesota Living With Failure 75% Kansas City Cardiomyopathy questionnaires). Major included bleeding, stroke, right failure, percutaneous lead infection. Pump thrombosis occurred 4 patients. Conclusions A provides effective hemodynamic least months awaiting life. (Thoratec HeartMate Left Ventricular Assist System [LVAS] Bridge Cardiac Transplantation; NCT00121472)