Clinical experience with 111 Thoratec ventricular assist devices

Background. Ventricular assist devices (VADs) have gained wider acceptance due to refinements in patient selection and management and device availabil ity. Methods. To evaluate early and late results, we reviewed our first 111 pati ents with the Thoratec VAD. Results. Forty-four patients were supported for myocardial recovery. The me an age in the recovery group was 51.9 years. There were 18 left VADs (LVADs ), 17 biventricular VADs (BVADs), and nine right VADs (RVADs). Complication s included bleeding in 20 patients (45%) and device-related infection in 1 patient (2%). Nineteen were weaned from the VAD, with 12 survivors. Sixty-s even patients were supported as a bridge to cardiac transplantation. The me an age was 41.5 years. There were 39 LVADs and 28 BVADs. Complications incl uded bleeding in 21 patients (31%) and device-related infection in 12 (18%) . Three patients were weaned and 39 patients were transplanted from the ass ist device, for a total of 42 bridge survivors. Device-related thromboembol ism occurred in 9 patients (8.1%), 7 of whom were bridge to transplantation . The duration of VAD support ranged from 0.1 to 27 days (mean 4.5 days) in the recovery group and 0.2 to 184 days (mean 40.7 days) in the bridge to t ransplantation group. The 10-year actuarial survival was 16% for the recove ry group, 22% for the bridge group, and 33% for transplanted patients. Conclusions. Despite advances, VAD support remains associated with signific ant morbidity and operative mortality. (Ann Thorac Surg 1999;67:1233-9) (C) 1999 by The Society of Thoracic Surgeons.