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CARDIOVASCULAR
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Volume 6, 2001, No 1 |
Successful
Bridge to Cardiac Transplantation Using Conventional Cardiac Assist Devices -
University of Alberta Experience
S. H. Wang, Y. Saiki, G. Singh, K. Scherr, A. Koshal, J. C. Mullen, D.
L. Modry
Background:
Cardiac transplantation is the established therapy of choice for end-stage heart
disease. Mechanical circulatory support has become an important, viable option
in stabilizing and bridging critically ill potential recipients for
transplantation. We present the experience of one Canadian institution with
conventional cardiac assist devices used as a bridge for heart transplant
recipients in cardiogenic shock.
Methods:
A
retrospective review of all adult cardiac transplant recipients performed from
July 1985 through September 2000 was carried out. Patients in cardiogenic shock
deemed to be potential transplant recipients, who were mechanically supported,
were examined. Those who subsequently received an organ were identified, and
survival analyzed. A chart review and transplant database was employed.
Results: A
total of 308 heart transplants were performed. Of the 13 recipients bridged to
transplant with IABP, 92.3% (n=12) survived >30 days, 84.6% (n=11) were alive
and well out of hospital >1 year. Eleven patients were bridged to transplant
with ECMO or VAD. Overall survival following transplantation was 81.8% (n=9)
beyond 30 days; 72.7% (n=8) were alive and well out of hospital >1 year.
Conclusions:
These data indicate that selected patients in cardiogenic shock supported with
conventional, readily available and inexpensive mechanical assistance may be
successfully transplanted. While the patient population is small, it is possible
to successfully bridge patients in cardiogenic shock to cardiac transplantation
using IABP, ECMO, and VAD with acceptable survival following transplantation.
(CVE. 2001; 6 (1): 12-15)
Key words: assist devices, bridge to transplant, mechanical circulatory assistance
Shao
Hua Wang, M.D.
Division of Cardiothoracic Surgery
University of Alberta
2H2.34 Walter C. Mackenzie Health Sciences Centre
8440-112 Street
Edmonton, Alberta, T6G 2B7
Canada
E-mail: swang@cha.ab.ca
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