BRIDGING TO TRANSPLANT - EQUAL EXTENDED SURVIVAL FOR PATIENTS UNDERGOING LVAD SUPPORT WHEN COMPARED WITH LONG-TERM MEDICAL-MANAGEMENT

Implantation of ventricular assist devices (VADs) to support patients awaiting cardiac transplant has become an effective means of assuring that these critically ill patients survive to transplant. The authors undertook a retrospective analysis of 115 consecutive patients listed for cardiac transplant from January 1992 through tune 1995. A VAD was implanted in 19 of these patients. Survival was calculated by intent t o treat from the time of transplant listing through heart transplant, if it occurred. The analysis demonstrates that the patients who underw ent implantation of a VAD as bridge to transplant had survival times s imilar to those of patients with medical management. These survival st atistics demonstrate the utility of VADs as an effective means to brid ge critically ill patients until a suitable donor organ becomes availa ble. In addition, as previous studies have suggested for acute results , earlier implementation and better patient selection may lead to impr oved long-term survival.