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J. Heart Lung Transplant. · Oct 2011
Successful use of a pneumatic biventricular assist device as a bridge to transplantation in cardiogenic shock.
- Jaime Moriguchi, Stephanie Davis, Rhodora Jocson, Fardad Esmailian, Abbas Ardehali, Hillel Laks, Murray Kwon, Michelle Kittleson, Jon Kobashigawa, Jignesh Patel, Daniel Marelli, Mark Plunkett, Ramin Beygui, and Richard Shemin.
- Cedars-Sinai Heart Institute, Los Angeles, California, USA. Jaime.Moriguchi@cshs.org
- J. Heart Lung Transplant. 2011 Oct 1; 30 (10): 1143-7.
BackgroundMechanical circulatory support is a highly effective technology to maintain organ perfusion in patients with cardiogenic shock as a bridge to transplantation. Although implantation of a left ventricular assist device alone is often the preferred configuration, patients with biventricular failure and significant end-organ dysfunction often require biventricular assistance.MethodsBetween January 2000 and September 2008, 80 patients with severe biventricular failure were accepted for heart transplantation and received a pneumatic biventricular assist devices as a bridge to transplant. Patients were retrospectively divided into 2 groups: those successfully bridged to transplant (Group A) and those who died (Group B). Patients were also divided into 2 periods of implantation: Group X (2000-2005) and Group Y (2006-2008, which used a multidiscipline selection process).ResultsOverall success rate to transplantation was 71.3%, with Group Y demonstrating an 82% success to transplant rate vs 63% in Group X. One-year actuarial survival after transplant was 89% compared with 92% in patients without a ventricular assist device. There were no statistically significant laboratory parameters between Groups A and B identifying potential risk factors for poor outcome.ConclusionBiventricular assist device therapy represents an effective and reliable means of supporting selected Interagency Registry for Mechanically Assisted Circulatory Support profile 1 patients as a bridge to transplantation, with excellent success to transplant rates and post-transplant survival.Copyright © 2011 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.
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