HeartMate Left Ventricular Assist System Exchange: Results and Technical Considerations
2009; Lippincott Williams & Wilkins; Volume: 55; Issue: 6 Linguagem: Inglês
10.1097/mat.0b013e3181bd446a
ISSN1538-943X
AutoresRobert Adamson, Walter P. Dembitsky, Sam Baradarian, J. Chammas, Brian E. Jaski, Peter Hoagland, Vicki McCalmont, K. Ortiz, Marsha Stahovich, Suzanne Chillcott,
Tópico(s)Cardiac Arrest and Resuscitation
ResumoThe duration times of left ventricular assist system (LVAS) support have increased because of prolonged wait times for transplant and the more frequent use of devices for destination therapy. The HeartMate LVAS, the only device approved for bridge to transplant and destination therapy, has limited durability, making replacement increasingly necessary. Since 1996, we have exchanged 19 left ventricular assist devices in 15 patients (11 men: mean age, 57.1 years; range, 33–77 years). Most of the devices (14) were replaced with the HeartMate vented electric/extended-lead vented electric pump; five devices were exchanged for a HeartMate II LVAS. Bearing failure was the most frequent reason for exchange (15 of 19 pumps); four of the 19 pumps also had active device-related infections at the time of exchange. There were no early deaths (30 days). Overall survival (Kaplan-Meier) was 85% at 1 year, 67% at 2 years, and 56% at 3 years. Three patients had transplants (mean, 518 days); six patients died during support (mean, 934 days), and six patients remain on LVAS support (mean, 1,219 days). One patient has been on device for over 6 years. Left ventricular assist devices exchange is becoming increasingly likely and can be associated with acceptably low-operative mortality rates and good intermediate-term survival.
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