Bridging to cardiac transplantation with the Thoratec ventricular assist device

Mechanical circulatory support has become an established procedure for brid ging patients to cardiac transplantation. One of the devices available is t he Thoratec VAD, which can be applied for univentricular or biventricular s upport. Between March 1992 and June 1997, 74 patients were bridged with Tho ratec VAD to cardiac transplantation. In 67 patients the system was applied exclusively (26 LVAD, 38 BVAD, 3 TAH), in 7 patients subsequently or in co mbination with another MCS device. 71.6% with exclusive Thoratec applicatio n underwent transplantation with a posttransplant survival rate of 90%, 4 p atients are still waiting. Transplant rate in LVAD and BVAD patients was 84 % and 71.4%, respectively, posttransplant survival 95.2% and 88%, respectiv ely. 28.6% with a combined application of Thoratec and another MCS device s urvived to be discharged from hospital. Main complications were bleeding, l iver failure, multiple organ failure, and infections. In terms of reliabili ty and efficacy the Thoratec VAD is the system of choice for mid-term appli cation in patients bridged to cardiac transplantation.