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Experience With a Long-term Pulsatile Ventricular Assist Device as a Bridge to Heart Transplant in Adults. | LitMetric

AI Article Synopsis

  • The study investigates the use of paracorporeal pulsatile-flow ventricular assist devices (VADs) as a bridge to transplant (BTT) in adults, highlighting their advantages and limitations compared to continuous-flow devices.
  • A retrospective analysis of patients treated with the EXCOR VAD from 2009 to 2015 was conducted, revealing that 80% of patients successfully received heart transplants after an average of 112 days of support.
  • The main complications encountered included infections, neurological issues, bleeding, and device malfunctions, indicating the need for close monitoring in patients using this VAD method.

Article Abstract

Introduction And Objectives: Most long-term ventricular assist devices (VADs) that are currently implanted are intracorporeal continuous-flow devices. Their main limitations include their high cost and inability to provide biventricular support. The aim of this study was to describe the results of using paracorporeal pulsatile-flow VADs as a bridge to transplant (BTT) in adult patients.

Methods: Retrospective analysis of the characteristics, complications, and outcomes of a single-center case series of consecutive patients treated with the EXCOR VAD as BTT between 2009 and 2015.

Results: During the study period, 25 VADs were implanted, 6 of them biventricular. Ventricular assist devices were indicated directly as a BTT in 12 patients and as a bridge to decision in 13 due to the presence of potentially reversible contraindications or chance of heart function recovery. Twenty patients (80%) were successfully bridged to heart transplant after a median of 112 days (range, 8-239). The main complications included infectious (52% of patients), neurological events (32%, half of them fatal), bleeding (28%), and VAD malfunction requiring component replacement (28%).

Conclusions: Eighty percent of patients with the EXCOR VAD as BTT achieved the goal after an average of almost 4 months of support. The most frequent complications were infectious, and the most severe were neurological. In our enivonment, the use of these pulsatile-flow VAD as BTT is a feasible strategy that obtains similar outcomes to those of intracorporeal continuous-flow devices.

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Source
http://dx.doi.org/10.1016/j.rec.2017.03.004DOI Listing

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