Ventricular Assist Devices as a Bridge to Cardiac Transplantation: The Ottawa Experience

Abstract

This article reports our experience with ventricular assist devices (VADs) as a bridge to cardiac transplantation. From 1991 to 2003, a total of 42 patients received a Thoratec VAD (Thoratec Laboratories Corporation Inc., Pleasanton, CA, U.S.A.) (Group T) and 12 patients received a Novacor VAD (WorldHeart Corporation, Ottawa, Canada) (Group N). Thirty Thoratec patients were transplanted compared to six in the Novacor group. Four more Novacor patients are still supported. Of the transplanted patients, 87% survived to hospital discharge in Group T and 67% in Group N. Infections affected 29% and 50% of Group T patients during support and post-transplantation, respectively, compared to 25% and 0%, respectively, in Group N. Neurologic complications affected 33% of patients in each group during support. Reopening rates for bleeding during support were 45% and 42% in Groups T and N, respectively. There were no significant differences in outcomes between the two groups. Our study demonstrated the effectiveness of VADs in bridging mortally ill cardiac patients to successful heart transplantation.

Infectious complications after pulsatile-flow and continuous-flow left ventricular assist device implantation

“…8,9,[33][34][35] CRBSIs tend to involve either Staphylococcus or Candida species. Meanwhile, device-related infections predominantly involve Gram-positive cocci (Staphylococcus or Enteroccoccus species), although Gram-negative infections were also present (involving Pseudomonas, Enterobacter or Klebsiella species).…”

Renal Failure in Patients with Left Ventricular Assist Devices

“…The incidence of AKI after LVAD implantation has been reported to range from 7% to 56% (Table 1) (20,21,23,26,29,44,47,(49)(50)(51)(52)(53)(54)(55)(56)(57)(58). There are multiple reasons for the large variation in AKI incidence, which include varying definitions for AKI, the time period during which the study was performed, the baseline severity of heart failure (INTERMACS level), and the incidence and severity of pre-existing RD.…”

Clinical effectiveness and cost-effectiveness of second- and third-generation left ventricular assist devices as either bridge to transplant or alternative to transplant for adults eligible for heart transplantation: systematic review and cost-effectiveness model

“…Health-related quality of life remains relatively static in HF patients who are medically managed, 102 and improves after receiving a VAD 53,103,104 or HT, 104-106 with improvements maintained for several years. 103,105,[107][108][109] Recipients of HT report better HRQoL than recipients of VAD.…”

“…103,105,[107][108][109] Recipients of HT report better HRQoL than recipients of VAD. 104 In the model, health outcomes were measured in QALYs, in accordance with current UK guidelines.…”