Temporary pulsatile ventricular assist devices and biventricular assist devices

Background. During the past years several systems for mechanical circulator y support have become available. In this study we describe our experience w ith short-term and mid-term application of the ABIOMED and Thoratec device. Methods. Since 1990 the ABIOMED BVS and since 1992 the Thoratec VAD have be en applied to 75 and 103 patients, respectively, with postcardiotomy heart failure, as a bridge-to-transplant procedure, and with different other indi cations. Results. In the ABIOMED collective 25 of 50 patients (50%) with postcardiot omy heart failure and 1 of 4 patients with miscellaneous other indications could be discharged from hospital, 7 of 14 bridge-to-transplant patients (5 0%) underwent transplantation with a posttransplant survival of 86%. In the Thoratec collective 6 of 10 patients (60%) with postcardiotomy heart failu re and 4 of 8 patients (50%) with miscellaneous indications could be discha rged from hospital, 48 bridge-to-transplant patients (74%) underwent transp lantation with a posttransplant survival of 90%. Conclusions. The results show the versatility of the Thoratec VAD for short -term and mid-term application in patients with postcardiotomy heart failur e and as a bridge-to-transplant procedure. The use of the ABIOMED device is not indicated for bridging patients to transplantation. Although in case o f postcardiotomy heart failure, Thoratec is also superior to ABIOMED, the h igh costs of the Thoratec VAD limits its wide acceptance in this patient co hort. (C) 1999 by The Society of Thoracic Surgeons.