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

This Article Full Text Full Text (PDF) 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): Patrick M. McCarthy Nicholas O. Smedira James B. Young Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by McCarthy, P. M. Articles by Young, J. B. Search for Related Content PubMed PubMed Citation Articles by McCarthy, P. M. Articles by Young, J. B.

J Thorac Cardiovasc Surg 1998;115:904-912
© 1998 Mosby, Inc.

CARDIOPULMONARY SUPPORT AND PHYSIOLOGY

One hundred patients with the HeartMate left ventricular assist device: evolving concepts and technology

From the Departments of Thoracic and Cardiovascular Surgery,^a Cardiology,^b and the Transplant Center,^c The Cleveland Clinic Foundation, Cleveland, Ohio.

Read at the Twenty-third Annual Meeting of The Western Thoracic Surgical Association, Napa, Calif., June 25-28, 1997.

Received for publication August 25, 1997; revisions requestedOct. 10, 1997; revisions received Dec. 1, 1997. Accepted for publication Dec. 5, 1997. Address for reprints: Patrick M McCarthy, MD, TheCleveland Clinic Foundation, Department of Thoracic and CardiovascularSurgery, 9500 Euclid Ave., F-25, Cleveland, OH 44195.

Background: Implantable left ventricular assist devices are common as a bridge to transplantation but are just reaching their goal as an alternative to transplantation.
Methods: From December 1991 until December 1996, 97 left ventricular assist devices were implanted as a bridge to transplantation, one as an alternative to transplantation, and two as a bridge to recovery. Included were 64 pneumatic devices and 36 electric devices. Most patients (69%) had ischemic cardiomyopathy and most (53%) had had previous cardiac surgery. Preoperative circulatory support (extracorporeal membrane oxygenation) was used in 25.
Results: Perioperative insertion of a right ventricular assist device was unusual (11%). The mean duration of support with a left ventricular assist device (bridge to transplantation) was 70 ± 41 days (up to 206 days). Survival to transplantation was 76%. Cause of death included multiple organ failure (n = 13), perioperative stroke (n = 5), device failure (n = 5), and controller disconnect (n = 1). Significant risk factors for death included (1) preoperative need for ventilator or extracorporeal membrane oxygenation, (2) elevated blood urea nitrogen, creatinine, or bilirubin, and (3) low pulmonary artery pressures. Risks after insertion of the left ventricular assist device were reoperation for bleeding, support with a right ventricular assist device, dialysis, or device failure. Catastrophic failure of the device occurred 14 times in 12 patients and was treated by emergency pump exchange in six instances. Only two device-related thromboembolic episodes were detected. Positive blood cultures were found in 59% of patients, driveline infection in 28%, and pump infection in 11%.
Conclusions: The HeartMate device provided excellent hemodynamic support with low device-related thromboembolic events. Infection and reliability of the device contributed to the high cost of therapy. These areas need to be improved for the left ventricular assist device to attain its goal as a viable alternative to transplantation.

This article has been cited by other articles:

				T. Niemi, S. Kukkonen, P. Hammainen, R. Suojaranta-Ylinen, and J. Sipponen Whole blood hypercoagulability despite anticoagulation during mechanical cardiac assist Perfusion, March 1, 2008; 23(2): 107 - 110. [Abstract] [PDF]

				S. Aggarwal, F. Cheema, M. C. Oz, and Y. Naka Long-Term Mechanical Circulatory Support Card. Surg. Adult, January 1, 2008; 3(2008): 1609 - 1628. [Full Text]

				M. S. Slaughter, S. S. Tsui, A. El-Banayosy, B. C. Sun, R. L. Kormos, D. K. Mueller, H. T. Massey, T. B. Icenogle, D. J. Farrar, J. D. Hill, et al. Results of a multicenter clinical trial with the Thoratec Implantable Ventricular Assist Device J. Thorac. Cardiovasc. Surg., June 1, 2007; 133(6): 1573 - 1580. [Abstract] [Full Text] [PDF]

				G. M. Wieselthaler, M. Riedl, H. Schima, O. Wagner, W. Waldhausl, E. Wolner, A. Luger, and M. Clodi Endocrine function is not impaired in patients with a continuous MicroMed-DeBakey axial flow pump J. Thorac. Cardiovasc. Surg., January 1, 2007; 133(1): 2 - 6. [Abstract] [Full Text] [PDF]

				R. J. Petrucci, K. C. Truesdell, A. Carter, N. E. Goldstein, M. M. Russell, D. Dilkes, J. M. Fitzpatrick, C. E. Thomas, M. E. Keenan, L. A. Lazarus, et al. Cognitive dysfunction in advanced heart failure and prospective cardiac assist device patients. Ann. Thorac. Surg., May 1, 2006; 81(5): 1738 - 1744. [Abstract] [Full Text] [PDF]

				B. G. Leshnower, T. G. Gleason, M. L. O'Hara, A. Pochettino, Y. J. Woo, R. J. Morris, T. J. Gardner, and M. A. Acker Safety and Efficacy of Left Ventricular Assist Device Support in Postmyocardial Infarction Cardiogenic Shock Ann. Thorac. Surg., April 1, 2006; 81(4): 1365 - 1371. [Abstract] [Full Text] [PDF]

				N. C. Dang, V. K. Topkara, B. T. Kim, M. L. Mercando, J. Kay, and Y. Naka Clinical outcomes in patients with chronic congestive heart failure who undergo left ventricular assist device implantation J. Thorac. Cardiovasc. Surg., November 1, 2005; 130(5): 1302 - 1309. [Abstract] [Full Text] [PDF]

				P. Feindt, U. Boeken, J.D. Schipke, J. Litmathe, N. Zimmermann, and E. Gams Ventricular constraint in dilated cardiomyopathy: A new, compliant textile mesh exerts prophylactic and therapeutic properties J. Thorac. Cardiovasc. Surg., October 1, 2005; 130(4): 1107 - 1107. [Abstract] [Full Text] [PDF]

				M. A. Simon, R. L. Kormos, S. Murali, P. Nair, M. Heffernan, J. Gorcsan, S. Winowich, and D. M. McNamara Myocardial Recovery Using Ventricular Assist Devices: Prevalence, Clinical Characteristics, and Outcomes Circulation, August 30, 2005; 112(9_suppl): I-32 - I-36. [Abstract] [Full Text] [PDF]

				H. Kemperman, M. van den Berg, H. Kirkels, and N. de Jonge B-Type Natriuretic Peptide (BNP) and N-Terminal proBNP in Patients with End-Stage Heart Failure Supported by a Left Ventricular Assist Device Clin. Chem., September 1, 2004; 50(9): 1670 - 1672. [Full Text] [PDF]

				T. Kohmoto, M. C. Oz, and Y. Naka Late bleeding from right internal mammary artery after heartmate left ventricular assist device implantation Ann. Thorac. Surg., August 1, 2004; 78(2): 689 - 691. [Abstract] [Full Text] [PDF]

				K. Doi, L. A. R. Golding, A. L. Massiello, M. W. Kopcak Jr, R. L. Gerhart, S. Schenk, M. Inoue, Y. Ootaki, and K. Fukamachi Preclinical readiness testing of the arrow international CorAide left ventricular assist system Ann. Thorac. Surg., June 1, 2004; 77(6): 2103 - 2110. [Abstract] [Full Text] [PDF]

				S. Chatterjee, N. N. Williams, M. L. Ohara, C. Twomey, J. B. Morris, and M. A. Acker Diaphragmatic hernias associated with ventricular assist devices and heart transplantation Ann. Thorac. Surg., June 1, 2004; 77(6): 2111 - 2114. [Abstract] [Full Text] [PDF]

				R. M. Lazar, P. A. Shapiro, B. E. Jaski, M. K. Parides, R. C. Bourge, J. T. Watson, L. Damme, W. Dembitsky, J. D. Hosenpud, L. Gupta, et al. Neurological Events During Long-Term Mechanical Circulatory Support for Heart Failure: The Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) Experience Circulation, May 25, 2004; 109(20): 2423 - 2427. [Abstract] [Full Text] [PDF]

				J. A. Morgan, R. John, V. Rao, A. D. Weinberg, B. J. Lee, P. A. Mazzeo, M. R. Flannery, J. M. Chen, M. C. Oz, and Y. Naka Bridging to transplant with the HeartMate left ventricular assist device: The Columbia Presbyterian 12-year experience J. Thorac. Cardiovasc. Surg., May 1, 2004; 127(5): 1309 - 1316. [Abstract] [Full Text] [PDF]

				S. J. Park, K. K. Liao, R. Segurola, K. P. Madhu, and L. W. Miller Management of aortic insufficiency in patients with left ventricular assist devices: A simple coaptation stitch method (Park's stitch) J. Thorac. Cardiovasc. Surg., January 1, 2004; 127(1): 264 - 266. [Full Text] [PDF]

				H. Granfeldt, B. Koul, L. Wiklund, B. Peterzen, U. Lonn, A. Babic, and H. C. Ahn Risk factor analysis of Swedish Left Ventricular Assist Device (LVAD) patients Ann. Thorac. Surg., December 1, 2003; 76(6): 1993 - 1998. [Abstract] [Full Text] [PDF]

				G. M. Wieselthaler, H. Schima, and E. Wolner Special considerations on the implantation technique for the MicroMed-DeBakey ventricular assist device axial pump Ann. Thorac. Surg., December 1, 2003; 76(6): 2109 - 2111. [Abstract] [Full Text] [PDF]

				G. V. Letsou, T. J. Myers, I. D. Gregoric, R. Delgado, N. Shah, K. Robertson, B. Radovancevic, and O. H. Frazier Continuous axial-flow left ventricular assist device (Jarvik 2000) maintains kidney and liver perfusion for up to 6 months Ann. Thorac. Surg., October 1, 2003; 76(4): 1167 - 1170. [Abstract] [Full Text] [PDF]

				V. Lacroix, Y. d'Udekem, L. Jacquet, and P. Noirhomme Resection of the ascending aorta and aortic valve patch closure for type A aortic dissection after Novacor(R) LVAD insertion Eur. J. Cardiothorac. Surg., August 1, 2003; 24(2): 309 - 311. [Abstract] [Full Text] [PDF]

				K. D. Aaronson, H. Patel, and F. D. Pagani Patient selection for left ventricular assist device therapy Ann. Thorac. Surg., June 1, 2003; 75(90060): S29 - 35. [Abstract] [Full Text] [PDF]

				L. W. Miller Patient selection for the use of ventricular assist devices as a bridge to transplantation Ann. Thorac. Surg., June 1, 2003; 75(90060): S66 - 71. [Abstract] [Full Text] [PDF]

				W. E. Richenbacher, Y. Naka, E. P. Raines, O. H. Frazier, G. S. Couper, F. D. Pagani, L. Damme, C. H. VanMeter, G. J. Magovern Jr, L. Gupta, et al. Surgical management of patients in the REMATCH trial Ann. Thorac. Surg., June 1, 2003; 75(90060): S86 - 92. [Abstract] [Full Text] [PDF]

				A. El-Banayosy, L. Arusoglu, L. Kizner, M. Morshuis, G. Tenderich, W. E. Pae Jr, and R. Korfer Preliminary experience with the LionHeart left ventricular assist device in patients with end-stage heart failure Ann. Thorac. Surg., May 1, 2003; 75(5): 1469 - 1475. [Abstract] [Full Text] [PDF]

				J. R. Lahpor Implantable Devices Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2003; 7(1): 111 - 112. [PDF]

				T. N.H. Drews, M. Loebe, M. J. Jurmann, Y. Weng, C. Wendelmuth, and R. Hetzer Outpatients on mechanical circulatory support Ann. Thorac. Surg., March 1, 2003; 75(3): 780 - 785. [Abstract] [Full Text] [PDF]

				U. N. Khot, M. Mishra, M. H. Yamani, N. G. Smedira, E. Paganini, M. Yeager, T. Buda, P. M. McCarthy, J. B. Young, and R. C. Starling Severe renal dysfunction complicating cardiogenic shock is not a contraindication to mechanical support as a bridge to cardiac transplantation J. Am. Coll. Cardiol., February 5, 2003; 41(3): 381 - 385. [Abstract] [Full Text] [PDF]

				J. G. Copeland Multicenter bridge to transplantation with the HeartMate assist device: Evaluation from another perspective J. Thorac. Cardiovasc. Surg., February 1, 2003; 125(2): 228 - 230. [Full Text] [PDF]

				S. Kono, K. Nishimura, T. Nishina, S. Yuasa, K. Ueyama, C. Hamada, T. Akamatsu, and M. Komeda Autosynchronized systolic unloading during left ventricular assist with a centrifugal pump J. Thorac. Cardiovasc. Surg., February 1, 2003; 125(2): 353 - 360. [Abstract] [Full Text] [PDF]

				J. L. Navia, P. M. McCarthy, K. J. Hoercher, N. G. Smedira, M. K. Banbury, and E. H. Blackstone Do left ventricular assist device (LVAD) bridge-to-transplantation outcomes predict the results of permanent LVAD implantation? Ann. Thorac. Surg., December 1, 2002; 74(6): 2051 - 2063. [Abstract] [Full Text] [PDF]

				V. Jeevanandam, D. Jayakar, A. S. Anderson, S. Martin, W. Piccione Jr, A.L. Heroux, J. Wynne, L. W. Stephenson, J. Hsu, P. S. Freed, et al. Circulatory Assistance With a Permanent Implantable IABP: Initial Human Experience Circulation, September 24, 2002; 106(12_suppl_1): I-183 - I-188. [Abstract] [Full Text] [PDF]

				M. Rothenburger, M. J. Wilhelm, D. Hammel, C. Schmidt, T. D. T. Tjan, D. Bocker, H. H. Scheld, and C. Schmid Treatment of Thrombus Formation Associated With the MicroMed DeBakey VAD Using Recombinant Tissue Plasminogen Activator Circulation, September 24, 2002; 106(12_suppl_1): I-189 - I-192. [Abstract] [Full Text] [PDF]

				Y. Ochiai, P. M. McCarthy, N. G. Smedira, M. K. Banbury, J. L. Navia, J. Feng, A. P. Hsu, M. L. Yeager, T. Buda, K. J. Hoercher, et al. Predictors of Severe Right Ventricular Failure After Implantable Left Ventricular Assist Device Insertion: Analysis of 245 Patients Circulation, September 24, 2002; 106(12_suppl_1): I-198 - I-202. [Abstract] [Full Text] [PDF]

				C. Faber, P. M. McCarthy, N. G. Smedira, J. B. Young, R. C. Starling, and K. J. Hoercher Implantable left ventricular assist device for patients with postinfarction ventricular septal defect J. Thorac. Cardiovasc. Surg., August 1, 2002; 124(2): 400 - 401. [Full Text] [PDF]

				M. P. Siegenthaler, J.u. Martin, A. van de Loo, T. Doenst, W. Bothe, and F. Beyersdorf Implantation of the permanent jarvik-2000 left ventricular assist device: A single-center experience J. Am. Coll. Cardiol., June 5, 2002; 39(11): 1764 - 1772. [Abstract] [Full Text] [PDF]

				K. D. Aaronson, M. J. Eppinger, D. B. Dyke, S. Wright, and F. D. Pagani Left ventricular assist device therapy improves utilization of donor hearts J. Am. Coll. Cardiol., April 17, 2002; 39(8): 1247 - 1254. [Abstract] [Full Text] [PDF]

				P. M. McCarthy Implantable left ventricular assist device bridge-to-transplantation: natural selection, or is this the natural selection? J. Am. Coll. Cardiol., April 17, 2002; 39(8): 1255 - 1257. [Full Text] [PDF]

				P. M. McCarthy and W. A. Smith Mechanical Circulatory Support--a Long and Winding Road Science, February 8, 2002; 295(5557): 998 - 999. [Abstract] [Full Text] [PDF]

				T. Masai, Y. Sawa, S. Ohtake, T. Nishida, M. Nishimura, N. Fukushima, T. Yamaguchi, and H. Matsuda Hepatic dysfunction after left ventricular mechanical assist in patients with end-stage heart failure: role of inflammatory response and hepatic microcirculation Ann. Thorac. Surg., February 1, 2002; 73(2): 549 - 555. [Abstract] [Full Text] [PDF]

				N. de Jonge, H. Kirkels, J. R. Lahpor, C. Klopping, E. J. Hulzebos, A. Brutel de la Riviere, and E. O. Robles de Medina Exercise performance in patients with end-stage heart failure after implantation of a left ventricular assist device and after heart transplantation: An outlook for permanent assisting? J. Am. Coll. Cardiol., June 1, 2001; 37(7): 1794 - 1799. [Abstract] [Full Text] [PDF]

				L. R. McBride, K. S. Naunheim, A. C. Fiore, R. G. Johnson, D. A. Moroney, J. A. Brannan, and M. T. Swartz Risk analysis in patients bridged to transplantation Ann. Thorac. Surg., June 1, 2001; 71(6): 1839 - 1844. [Abstract] [Full Text] [PDF]

				F. D. Pagani, K. D. Aaronson, F. Swaniker, and R. H. Bartlett The use of extracorporeal life support in adult patients with primary cardiac failure as a bridge to implantable left ventricular assist device Ann. Thorac. Surg., March 1, 2001; 71 (2007): S77 - S81. [Abstract] [Full Text] [PDF]

				A. El-Banayosy, R. Korfer, L. Arusoglu, L. Kizner, M. Morshuis, H. Milting, G. Tenderich, O. Fey, and K. Minami Device and patient management in a bridge-to-transplant setting Ann. Thorac. Surg., March 1, 2001; 71 (2007): S98 - S102. [Abstract] [Full Text] [PDF]

				G. S. Kumpati, P. M. McCarthy, and K. J. Hoercher Left ventricular assist device bridge to recovery: a review of the current status Ann. Thorac. Surg., March 1, 2001; 71 (2007): S103 - S108. [Abstract] [Full Text] [PDF]

				G. M. Wieselthaler, H. Schima, A. M. Lassnigg, M. Dworschak, R. Pacher, M. Grimm, and E. Wolner Lessons learned from the first clinical implants of the DeBakey ventricular assist device axial pump: a single center report Ann. Thorac. Surg., March 1, 2001; 71 (2007): S139 - S143. [Abstract] [Full Text] [PDF]

				S. H. Reichenbach, D. J. Farrar, and J. D. Hill A versatile intracorporeal ventricular assist device based on the Thoratec VAD system Ann. Thorac. Surg., March 1, 2001; 71 (2007): S171 - S175. [Abstract] [Full Text] [PDF]

				F. D. Pagani, K. D. Aaronson, D. B. Dyke, S. Wright, F. Swaniker, and R. H. Bartlett Assessment of an extracorporeal life support to LVAD bridge to heart transplant strategy Ann. Thorac. Surg., December 1, 2000; 70(6): 1977 - 1985. [Abstract] [Full Text] [PDF]

				G. A. Thomas, R. L. Hammond, K. Greer, H. Lu, J. C. Jarvis, A. P. Shortland, D. M. Pullan, S. Salmons, and L. W. Stephenson Functional assessment of skeletal muscle ventricles after pumping for up to four years in circulation Ann. Thorac. Surg., October 1, 2000; 70(4): 1281 - 1289. [Abstract] [Full Text] [PDF]

				A. Koster, M. Loebe, R. Hansen, E. V. Potapov, G. P. Noon, H. Kuppe, and R. Hetzer Alterations in coagulation after implantation of a pulsatile Novacor LVAD and the axial flow micromed DeBakey LVAD Ann. Thorac. Surg., August 1, 2000; 70(2): 533 - 537. [Abstract] [Full Text] [PDF]

				D. Marelli, H. Laks, D. Fazio, M. A. Hamilton, G. C. Fonarow, D. A. Meehan, and J. D. Moriguchi Mechanical assist strategy using the BVS 5000i for patients with heart failure Ann. Thorac. Surg., July 1, 2000; 70(1): 59 - 66. [Abstract] [Full Text] [PDF]

				A El-Banayosy, L Arusoglu, L Kizner, O Fey, K Minami, and R Korfer Complications of circulatory assist Perfusion, July 1, 2000; 15(4): 327 - 331. [PDF]

				S G Williams, D J Wright, and L B Tan Management of cardiogenic shock complicating acute myocardial infarction: towards evidence based medical practice Heart, June 1, 2000; 83(6): 621 - 626. [Full Text]

				A. J. Bank, S. H. Mir, D. Q. Nguyen, R. M. Bolman III, S. J. Shumway, L. W. Miller, D. R. Kaiser, S. M. Ormaza, and S. J. Park Effects of left ventricular assist devices on outcomes in patients undergoing heart transplantation Ann. Thorac. Surg., May 1, 2000; 69(5): 1369 - 1374. [Abstract] [Full Text] [PDF]

				S. J. Park, D. Q. Nguyen, A. J. Bank, S. Ormaza, and R. M. Bolman III Left ventricular assist device bridge therapy for acute myocardial infarction Ann. Thorac. Surg., April 1, 2000; 69(4): 1146 - 1151. [Abstract] [Full Text] [PDF]

				R.-B. Hsu, S.-H. Chu, and S.-S. Wang Simple method of hemostasis in implantation and explantation of HeartMate left ventricular assist device Eur. J. Cardiothorac. Surg., March 1, 2000; 17(3): 336 - 337. [Abstract] [Full Text] [PDF]

				A. El-Banayosy, L. Arusoglu, L. Kizner, G. Tenderich, K. Minami, K. Inoue, and R. Korfer NOVACOR LEFT VENTRICULAR ASSIST SYSTEM VERSUS HEARTMATE VENTED ELECTRIC LEFT VENTRICULAR ASSIST SYSTEM AS A LONG-TERM MECHANICAL CIRCULATORY SUPPORT DEVICE IN BRIDGING PATIENTS: A PROSPECTIVE STUDY J. Thorac. Cardiovasc. Surg., March 1, 2000; 119(3): 581 - 587. [Abstract] [Full Text] [PDF]

				P. Mohacsi, M. C. Deng, R. Murphy, C.-H. Bergh, E. Gronda, M. Komajda, R. Pacher, J. Spinar, K. Swedberg, and J. F. Cleland Implantable left ventricular assist systems (LVAS): Recent results. A report from a series of meetings sponsored by the Study Group on Advanced Heart Failure of the Working Group on Heart Failure Eur J Heart Fail, March 1, 2000; 2(1): 13 - 18. [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]

				L. Arusoglu, R. Koerfer, G. Tenderich, W. A. Alexander, and A. El-Banayosy A novel method to reduce device-related infections in patients supported with the HeartMate device Ann. Thorac. Surg., November 1, 1999; 68(5): 1875 - 1877. [Abstract] [Full Text] [PDF]

				E. B. Savage, T. A. d'Amato, and J. A. Magovern Aortic valve patch closure: an alternative to replacement with HeartMate(R) LVAS insertion Eur. J. Cardiothorac. Surg., September 1, 1999; 16(3): 359 - 361. [Abstract] [Full Text] [PDF]

				L. R. McBride, K. S. Naunheim, A. C. Fiore, D. A. Moroney, and M. T. Swartz Clinical experience with 111 thoratec ventricular assist devices Ann. Thorac. Surg., May 1, 1999; 67(5): 1233 - 1238. [Abstract] [Full Text] [PDF]

				D. L. Mann and J. T. Willerson Left Ventricular Assist Devices and the Failing Heart : A Bridge to Recovery, a Permanent Assist Device, or a Bridge Too Far? Circulation, December 1, 1998; 98(22): 2367 - 2369. [Full Text] [PDF]

				Prolonged LVAD Support Remains Problematic Journal Watch Cardiology, May 22, 1998; 1998(522): 9 - 9. [Full Text]