Clinical experience with 111 thoratec ventricular assist devices
Autor: | Lawrence R. McBride, Debbie A Moroney, Keith S. Naunheim, Marc T. Swartz, Andrew C. Fiore |
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Rok vydání: | 1999 |
Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Adolescent Myocardial Infarction Actuarial survival law.invention Postoperative Complications law Artificial heart parasitic diseases medicine Humans In patient cardiovascular diseases Aged Retrospective Studies business.industry Operative mortality Mean age Middle Aged Survival Analysis Late results Surgery Transplantation Treatment Outcome Heart Transplantation Female Bridge to transplantation Heart-Assist Devices Cardiology and Cardiovascular Medicine business |
Zdroj: | The Annals of Thoracic Surgery. 67:1233-1238 |
ISSN: | 0003-4975 |
DOI: | 10.1016/s0003-4975(99)00246-5 |
Popis: | Background . Ventricular assist devices (VADs) have gained wider acceptance due to refinements in patient selection and management and device availability. Methods . To evaluate early and late results, we reviewed our first 111 patients with the Thoratec VAD. Results . Forty-four patients were supported for myocardial recovery. The mean age in the recovery group was 51.9 years. There were 18 left VADs (LVADs), 17 biventricular VADs (BVADs), and nine right VADs (RVADs). Complications included bleeding in 20 patients (45%) and device-related infection in 1 patient (2%). Nineteen were weaned from the VAD, with 12 survivors. Sixty-seven patients were supported as a bridge to cardiac transplantation. The mean age was 41.5 years. There were 39 LVADs and 28 BVADs. Complications included bleeding in 21 patients (31%) and device-related infection in 12 (18%). Three patients were weaned and 39 patients were transplanted from the assist device, for a total of 42 bridge survivors. Device-related thromboembolism occurred in 9 patients (8.1%), 7 of whom were bridge to transplantation. The duration of VAD support ranged from 0.1 to 27 days (mean 4.5 days) in the recovery group and 0.2 to 184 days (mean 40.7 days) in the bridge to transplantation group. The 10-year actuarial survival was 16% for the recovery group, 22% for the bridge group, and 33% for transplanted patients. Conclusions . Despite advances, VAD support remains associated with significant morbidity and operative mortality. |
Databáze: | OpenAIRE |
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