| Popis: |
Candidates for heart transplantation face increasingly lengthy waits for donor hearts. In the United States, candidates may wait for well over 12 months (United Network of Organ Sharing statistics for 1994), and during this period, life-threatening deteriorations in their condition often occur. When death is imminent or when survival to transplant is unlikely given declining clinical condition, mechanical circulatory support can often be successfully utilized to bridge patients to cardiac transplantation. By mid-1992, a total of 380 persons had received one of the four most-used types of ventricular assist devices approved as bridges in the United States (38). These devices include the Pierce-Donachy Assist Device (Thoratec, Berkeley, CA) (n = 172 bridged patients by August, 1992); the Abiomed BVS-5000 (Abiomed Cardiovascular Inc., Danvers, MA) (n = 58 patients); the Novacor Left Ventricular Assist System (Novacor Division, Baxter Health Care Corporation, Oakland, CA) (n = 124 patients), and the CardioWest device (CardioWest, Inc., Tempe, AZ) (n = 26 patients). Clinical reports of patients supported by these and similar devices approved more recently show not only remarkable physical rehabilitation in many cases after device insertion, but excellent post-transplant survival rates that meet and sometimes exceed survival rates in nonbridged patients (21,38). |
