HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Bartley P. Griffith Robert L. Kormos Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Griffith, B. P. Articles by Pristas, J. M. Search for Related Content PubMed PubMed Citation Articles by Griffith, B. P. Articles by Pristas, J. M.

Ann Thorac Surg 1996;61:396-398
© 1996 The Society of Thoracic Surgeons

---

Extended Bridge: Permanent Implantation

Results of Extended Bridge to Transplantation: Window Into the Future of Permanent Ventricular Assist Devices

Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania

Abstract

Background. There is interest in expanding ventricular assist device use from short-term bridging to transplantation to long-term and permanent support.

Methods. We have reviewed the outcome of 162 patients who had a mechanical bridge to transplantation that lasted at least 60 days. Eighty-five patients received the HeartMate, 40 the Novacor, and 37 the Thoratec device.

Results. Of the 162 patients, 125 received transplants, and 115 survived after transplantation (93%). Within the group there were 174 complications including 54 infections of the driveline, 73 other infections, and thromboembolic strokes in 47. Infections of the driveline were considered major in 24 of 54 cases, and other infections were major in 36 of 73 cases. Twenty-seven of those who sustained thromboembolic events had residual effects. Of 11 patients with a major stroke and infection, only 1 survived transplantation. Eighty-two patients were supported between 60 and 100 days, 63 patients between 101 and 200 days, 12 patients between 201 and 300 days, and only 5 patients in excess of 300 days. A greater percentage of candidates died waiting between 101 and 200 days than between 60 and 100 days (25% versus 10%). The incidence of complications also rose in those patients bridged more than 100 days.

Conclusions. The data reinforce the excellent results obtained in the bridge to transplantation trials that reported a shorter duration of support. For those interested in extended bridge to transplantation or permanent use of the currently available devices, the results suggest reasonable success can be anticipated, but the serious infections and strokes tend to be more common with longer duration of support.

This article has been cited by other articles:

				J. O. Robertson, C. Lober, N. G. Smedira, J. L. Navia, N. Sopko, and G. V. Gonzalez-Stawinski One hundred days or more bridged on a ventricular assist device and effects on outcomes following heart transplantation. Eur. J. Cardiothorac. Surg., August 1, 2008; 34(2): 295 - 300. [Abstract] [Full Text] [PDF]

				S. Westaby, R. Jarvik, A. Freeland, D. Pigott, D. Robson, S. Saito, P. Catarino, and O. H. Frazier Postauricular percutaneous power delivery for permanent mechanical circulatory support J. Thorac. Cardiovasc. Surg., May 1, 2002; 123(5): 977 - 983. [Abstract] [Full Text] [PDF]

				W. L. Holman, J. E. Davies, B. K. Rayburn, D. C. McGiffin, B. A. Foley, R. L. Benza, R. C. Bourge, P. Blood, and J. K. Kirklin Treatment of end-stage heart disease with outpatient ventricular assist devices Ann. Thorac. Surg., May 1, 2002; 73(5): 1489 - 1494. [Abstract] [Full Text] [PDF]

				P. J. Hauptman, M. Jimenez-Navarro, E. Molero, E. de Teresa, R. A. Vilchez, R. Kormos, S. Kusne, B. Stiller, P. E. Lange, R. Hetzer, et al. Left Ventricular Assist Device N. Engl. J. Med., March 28, 2002; 346(13): 1023 - 1025. [Full Text] [PDF]

				S. M. Gordon, S. K. Schmitt, M. Jacobs, N. M. Smedira, M. Goormastic, M. K. Banbury, M. Yeager, J. Serkey, K. Hoercher, and P. M. McCarthy Nosocomial bloodstream infections in patients with implantable left ventricular assist devices Ann. Thorac. Surg., September 1, 2001; 72(3): 725 - 730. [Abstract] [Full Text] [PDF]

				A K Mahmood, J M Courtney, S Westaby, M Akdis, and H Reul Critical review of current left ventricular assist devices Perfusion, September 1, 2000; 15(5): 399 - 420. [PDF]

				J. R Pepper Surgery for heart failure: options and outcomes Perfusion, July 1, 2000; 15(4): 287 - 293. [PDF]

				D. R. Fastenau and J. A. McIntyre Immunochemical analysis of polyspecific antibodies in patients exposed to bovine fibrin sealant Ann. Thorac. Surg., June 1, 2000; 69(6): 1867 - 1872. [Abstract] [Full Text] [PDF]

				R. Korfer, A. El-Banayosy, L. Arusoglu, K. Minami, M. M. Korner, L. Kizner, O. Fey, U. Schutt, M. Morshuis, and H. Posival SINGLE-CENTER EXPERIENCE WITH THE THORATEC VENTRICULAR ASSIST DEVICE J. Thorac. Cardiovasc. Surg., March 1, 2000; 119(3): 596 - 600. [Abstract] [Full Text] [PDF]

				K. Fukamachi, P. M. McCarthy, N. G. Smedira, R. L. Vargo, R. C. Starling, and J. B. Young Preoperative risk factors for right ventricular failure after implantable left ventricular assist device insertion Ann. Thorac. Surg., December 1, 1999; 68(6): 2181 - 2184. [Abstract] [Full Text] [PDF]

				D. R. Fastenau, D. R. Wagenknecht, and J. A. McIntyre Increased incidence of antiphospholipid antibodies in left ventricular assist system recipients Ann. Thorac. Surg., July 1, 1999; 68(1): 137 - 142. [Abstract] [Full Text] [PDF]

				R. Jarvik, S. Westaby, T. Katsumata, D. Pigott, and R. D. Evans LVAD Power Delivery: A Percutaneous Approach to Avoid Infection Ann. Thorac. Surg., February 1, 1998; 65(2): 470 - 473. [Abstract] [Full Text] [PDF]