Single-center experience with the Thoratec ventricular assist device

Objective: The Thoratec ventricular assist device (Thoratec Laboratories, P leasanton, Calif) is widely accepted for univentricular and biventricular s upport in patients with various indications, The aim of this study is to de scribe our experience with implantation of the Thoratec ventricular assist device in more than 100 patients, Methods: From March 1992 to June 1998, 11 4 patients (98 men and 15 women; mean age, 47.9 years) received the Thorate c ventricular assist device for a mean duration of 44.9 days. The patients were divided into 3 groups. Group 1 included 84 patients in whom the system was applied as a bridge-to-transplant procedure. Group 2 included 17 patie nts with postcardiotomy cardiogenic shock, and group 3 included 13 patients with cardiogenic shock of other causes. Results: Sixty-eight percent of pa tients in group 1 survived to transplantation with a posttransplant surviva l of 88%. The only independent risk factor affecting survival was age more than 60 years. Survivals in groups 2 and 3 were 47% and 31%, respectively. Main complications in all groups were bleeding, multiple organ failure, liv er failure, sepsis, and neurologic disorders. Conclusions: The Thoratec ven tricular assist device has proved to be a reliable device for bridge to tra nsplantation and postcardiotomy support. Further studies are required on pa tient selection and on patient and device management to reduce the incidenc e of complications in these patient populations.