Paracorporeal ventricular assist device as a bridge to transplant candidacy in the era of implantable continuous-flow ventricular assist device

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• 作者：Hideaki Suwa (1)
  Osamu Seguchi (2)
  Tomoyuki Fujita (3)
  Yoshihiro Murata (2)
  Michinari Hieda (2)
  Takuya Watanabe (2)
  Takuma Sato (2)
  Haruki Sunami (2)
  Masanobu Yanase (2)
  Hiroki Hata (3)
  Takeshi Nakatani (2)
  
• 关键词：Ventricular assist device ; Bridge to transplant candidacy ; Implantable continuous ; flow ventricular assist device ; Paracorporeal pulsatile ; flow ventricular assist device
• 刊名：Journal of Artificial Organs
• 出版年：2014
• 出版时间：March 2014
• 年：2014
• 卷：17
• 期：1
• 页码：16-22
• 全文大小：243 KB
• 参考文献：1. Miller LW, Pagani FD, Russell SD, John R, Boyle AJ, Aaronson KD, Conte JV, Naka Y, Mancini D, Delgado RM, MacGillivray TE, Farrar DJ, Frazier OH, HeartMate II Clinical Investigators. Use of a continuous-flow device in patients awaiting heart transplantation. N Engl J Med. 2007;357:885-6. CrossRef
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• 作者单位：Hideaki Suwa (1)
  Osamu Seguchi (2)
  Tomoyuki Fujita (3)
  Yoshihiro Murata (2)
  Michinari Hieda (2)
  Takuya Watanabe (2)
  Takuma Sato (2)
  Haruki Sunami (2)
  Masanobu Yanase (2)
  Hiroki Hata (3)
  Takeshi Nakatani (2)
  
  1. Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan
  2. Department of Transplantation, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan
  3. Department of Adult Cardiac Surgery, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan
  
• ISSN：1619-0904

文摘

Ventricular assist devices (VADs) have long been used as bridge to transplant therapy (BTT). Nipro-Toyobo paracorporeal pulsatile-flow VAD (nt-VAD) was the only device available until April 2011, when implantable continuous-flow VADs (cf-VADs) became available. Although cf-VADs are central to BTT, nt-VAD remains a necessary option. We aimed to clarify the role of nt-VAD in an era of increasing cf-VAD use. We retrospectively reviewed patients who underwent VAD implantation at the National Cerebral and Cardiovascular Center from May 2011 to March 2013. Characteristics were compared between the nt-VAD and cf-VAD groups. Twenty-nine patients (mean age 37.7?±?11.1?years, 23 males) underwent VAD implantation. Fifteen patients initially received nt-VADs, although 4 were converted to cf-VADs. Of these 15 patients, 3 were too small for cf-VADs and 2 needed bilateral ventricular support. The remaining 10 patients received nt-VADs (7 patients at INTERMACS level 1 and 3 at level 2). The nt-VAD group patients had significantly more preoperative mechanical circulatory support and were in a more critical condition before VAD implantation than the cf-VAD group. The 2-year survival rate was not significantly different. Despite the critical conditions of nt-VAD patients, their overall survival is not statistically inferior to that of cf-VAD patients. nt-VAD is a good option as a BTC for the patient with urgent and critical condition.