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The Annals of Thoracic Surgery, Vol 57, 51-57, Copyright © 1994 by The Society of Thoracic Surgeons
RL Kormos, S Murali, MA Dew, JM Armitage, RL Hardesty, HS Borovetz and BP Griffith
Because of donor scarcity, 12 (39%) of a series of 31 Novacor left
ventricular assist system recipients required mechanical circulatory
support for an average of 125 days before transplantation (range, 61 to 303
days). Ten received a heart transplant and all survived to discharge. Two
died of infection before transplantation after 93 and 303 days of support.
Significant reductions were noted from preimplantation values of right and
left cardiac filling pressures. Right ventricular ejection fraction and
cardiac index increased. The 4- month actuarial freedom from infection
during support was 75%. Three patients benefited from chronic outpatient
housing for 5, 18, and 131 days, respectively, with improvements in quality
of life measures. Ten chronically supported patients participated in an
intensive rehabilitative exercise program resulting in an improvement of
New York Heart Association class from IV to I in 9 patients. Mean oxygen
consumption, which was 10 mL.kg-1.min-1 30 days after implantation (mean
exercise time, 10 minutes) had risen to 15 mL.kg-1.min-1 before
transplantation (mean exercise time, 16 minutes). This series suggests that
long-term circulatory support is compatible with low morbidity, significant
physical and hemodynamic rehabilitation, and an outpatient setting.
ARTICLES
Chronic mechanical circulatory support: rehabilitation, low morbidity, and superior survival
Department of Medicine, University of Pittsburgh Medical Center, Pennsylvania.
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H. O. Vetter, H. G. Kaulbach, C. Schmitz, A. Forst, P. Uberfuhr, E. Kreuzer, M. Pfeiffer, P. Brenner, O. Dewald, B. Reichart, et al. Experience with the Novacor left ventricular assist system as a bridge to cardiac transplantation, including the new wearable system J. Thorac. Cardiovasc. Surg., January 1, 1995; 109(1): 74 - 80. [Abstract] [Full Text]
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