Skip to main content
SpringerLink
Log in

Mechanical Circulatory Support as a Bridge to Transplantation

  • Chapter
  • First Online:
Surgical Treatment for Advanced Heart Failure

  • 1362 Accesses

Abstract

Left ventricular assist devices represent the standard of care for bridging patients with end-stage heart failure to cardiac transplantation. Significant progress has been made over the last 10 years with respect to evolution of devices technology, patient selection, surgical techniques, and postoperative management of patients with LVADs. In this chapter, we review options for device therapy for bridge to transplant, important factors that relate to patient selection, surgical implantation technique, concomitant procedures performed with LVAD implantation, postoperative management, and complications of device therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Morgan JA, John R, Rao V, et al. Bridging to transplant with the Heartmate left ventricular assist device: the Columbia Presbyterian twelve-year experience. J Thorac Cardiovasc Surg. 2004;127(5):1309–16.

    Article  PubMed  Google Scholar 

  2. Dang NC, Topkara VK, Kim BT, et al. Clinical outcomes in patients with chronic congestive heart failure who undergo left ventricular assist device implantation. J Thorac Cardiovasc Surg. 2005;130(5):1302–9.

    Article  PubMed  Google Scholar 

  3. Rose EA, Gelijns AC, Moskowitz AJ, Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) Study Group, et al. Long-term mechanical left ventricular assistance for end-stage heart failure. N Engl J Med. 2001;345(20):1435–43.

    Article  PubMed  CAS  Google Scholar 

  4. DeRose JJ, Umana JP, Argenziano M, et al. Implantable left ventricular assist devices provide an excellent outpatient bridge to transplantation and recovery. J Am Coll Cardiol. 1997;30:1773–7.

    Article  PubMed  Google Scholar 

  5. Morales DL, Catanese KA, Helman DN, et al. Six-year experience of caring for forty four patients with a left ventricular assist device at home: safe, economical, necessary. J Thorac Cardiovasc Surg. 2000;119:251–9.

    Article  PubMed  CAS  Google Scholar 

  6. Dowling RD, Park SJ, Pagani FD, et al. Heartmate VE LVAS design enhancements and its impact on device reliability. Eur J Cardiothorac Surg. 2004;25(6):958–63.

    Article  PubMed  CAS  Google Scholar 

  7. Frazier OH. The development of an implantable, portable, electrically powered left ventricular assist device. Semin Thorac Cardiovasc Surg. 1994;6:181–7.

    PubMed  CAS  Google Scholar 

  8. Oz MC, Rose EA, Levin HR. Selection criteria for placement of left ventricular assist devices. Am Heart J. 1995;129:173–7.

    Article  PubMed  CAS  Google Scholar 

  9. Deng MC, Loebe M, El Banayosy A, et al. Mechanical circulatory support for advanced heart failure: effect of patient selection on outcome. Circulation. 2001;103:231–7.

    Article  PubMed  CAS  Google Scholar 

  10. Dang NC, Topkara VK, Leacche M, et al. Left ventricular assist device implantation after acute anterior wall myocardial infarction and cardiogenic shock: a two-center study. J Thorac Cardiovasc Surg. 2005;130(3):693–8.

    Article  PubMed  Google Scholar 

  11. Topkara VK, Dang NC, Barili F, et al. Ventricular assist device use for the treatment of acute viral myocarditis. J Thorac Cardiovasc Surg. 2006;131(5):1190–1.

    Article  PubMed  Google Scholar 

  12. Farrar DJ, Hill JD, Gray LA, et al. Successful biventricular circulatory support as a bridge to cardiac transplantation during prolonged ventricular fibrillation and asystole. Circulation. 1989;80:III147–51.

    PubMed  CAS  Google Scholar 

  13. Kherani AR, Cheema FH, Oz MC, et al. Implantation of a left ventricular assist device and the hub-and-spoke system in treating acute cardiogenic shock: who survives? J Thorac Cardiovasc Surg. 2003;126(5):1634–5.

    Article  PubMed  Google Scholar 

  14. Oz MC, Argenziano M, Catanese KA, et al. Bridge experience with long-term implantable left ventricular assist devices. Are they an alternative to transplantation? Circulation. 1997;95:1844–52.

    Article  PubMed  CAS  Google Scholar 

  15. Park SJ, Tector A, Piccioni W, et al. Left ventricular assist devices as destination therapy: a new look at survival. J Thorac Cardiovasc Surg. 2005;129(1):9–17.

    Article  PubMed  Google Scholar 

  16. Kormos RL, Murali S, Dew MA, et al. Chronic mechanical circulatory support: rehabilitation, low morbidity, and superior survival. Ann Thorac Surg. 1994;57:51–7.

    Article  PubMed  CAS  Google Scholar 

  17. Sun BC, Catanese KA, Spanier TB, et al. 100 long-term implantable left ventricular assist devices: the Columbia Presbyterian interim experience. Ann Thorac Surg. 1999;68:688–94.

    Article  PubMed  CAS  Google Scholar 

  18. Ashton RC, Goldstein DJ, Rose EA, et al. Duration of left ventricular assist device support affects transplant survival. J Heart Lung Transplant. 1996;15:1151–7.

    PubMed  Google Scholar 

  19. Morgan JA, Flannery MF, Kherani AR, et al. Effects of changes in UNOS policy regarding left ventricular assist devices. J Heart Lung Transplant. 2004;23(5):621–3.

    Article  Google Scholar 

  20. Morgan JA, Park Y, Kherani AR, et al. Does bridging to transplant with a left ventricular assist device adversely affect post-transplant survival? A comparative analysis of mechanical versus inotropic support. J Thorac Cardiovasc Surg. 2003;126(4):1188–90.

    Article  PubMed  Google Scholar 

  21. Deng MC, Weyand M, Hammel D, et al. Selection and outcome of ventricular assist device patients: the Muenster experience. J Heart Lung Transplant. 1998;17:817–25.

    PubMed  CAS  Google Scholar 

  22. Oz MC, Goldstein DJ, Pepino P, et al. Screening scale predicts patients successfully receiving long-term implantable left ventricular assist devices. Circulation. 1995;92:II169–73.

    PubMed  CAS  Google Scholar 

  23. Rao V, Oz MC, Flannery MA, et al. Revised screening scale to predict survival after insertion of a left ventricular assist device. J Thorac Cardiovasc Surg. 2003;125:855–62.

    Article  PubMed  Google Scholar 

  24. Dang NC, Topkara VK, Mercando M, et al. Right heart failure after left ventricular assist device implantation in patients with chronic congestive heart failure. J Heart Lung Transplant. 2006;25(1):1–6.

    Article  PubMed  Google Scholar 

  25. Fukamachi K, McCarthy PM, Smedira NG, et al. Preoperative risk factors for right ventricular failure after implantable left ventricular assist device insertion. Ann Thorac Surg. 1999;68:2181–4.

    Article  PubMed  CAS  Google Scholar 

  26. Topkara VK, Dang NC, Barili F, et al. Predictors and outcomes of continuous veno-venous hemodialysis use after implantation of a left ventricular assist device. J Heart Lung Transplant. 2006;25(4):404–8.

    Article  PubMed  Google Scholar 

  27. Topkara VK, Dang NC, Martens TP, et al. Bridging to transplantation with left ventricular assist devices: outcomes in patients aged 60 years and older. J Thorac Cardiovasc Surg. 2005;130(3):881–2.

    Article  PubMed  Google Scholar 

  28. Schulman AR, Martens TP, Christos PJ, et al. Comparisons of infection complications between continuous flow and pulsatile flow left ventricular assist devices. J Thorac Cardiovasc Surg. 2007;133(3):841–2.

    Article  PubMed  Google Scholar 

  29. Argenziano M, Catanese KA, Moazami N, et al. The influence of infection on survival and successful transplantation in patients with left ventricular assist devices. J Heart Lung Transplant. 1997;16:822–31.

    PubMed  CAS  Google Scholar 

  30. Morgan JA, John R, Lee BJ, et al. Is severe right ventricular failure in LVAD recipients a risk factor for unsuccessful bridging to transplant and post-transplant mortality. Ann Thorac Surg. 2004;77(3):859–63.

    Article  PubMed  Google Scholar 

  31. Farrar DJ. The thoratec ventricular assist device: a paracorporeal pump for treating acute and chronic heart failure. Semin Thorac Cardiovasc Surg. 2000;12:243–50.

    PubMed  CAS  Google Scholar 

  32. Farrar DJ, Hill JD, Pennington DG, et al. Preoperative and postoperative comparison of patients with ­univentricular and biventricular support with the thoratec ventricular assist device as a bridge to cardiac transplantation. J Thorac Cardiovasc Surg. 1997;113:202–9.

    Article  PubMed  CAS  Google Scholar 

  33. Samuels LE, Holmes EC, Hagan K, et al. The Thoratec Implantable Ventricular Assist Device (IVAD): initial clinical experience. Heart Surg Forum. 2006;9(4):E690–2.

    Article  PubMed  Google Scholar 

  34. Slaughter MS, Tsui SS, El-Banayosy A, et al. Results of a multicenter clinical trial with the Thoratec Implantable Ventricular Assist Device. J Thorac Cardiovasc Surg. 2007;133(6):1573–80.

    Article  PubMed  Google Scholar 

  35. Sezai A, Shiono M, Orime Y, et al. Major organ function under mechanical support: comparative studies of pulsatile and nonpulsatile circulation. Artif Organs. 1999;23:280–5.

    Article  PubMed  CAS  Google Scholar 

  36. Feller ED, Sorensen EN, Haddad M, et al. Clinical outcomes are similar in pulsatile and nonpulsatile left ventricular assist device recipients. Ann Thorac Surg. 2007;83(3):1082–8.

    Article  PubMed  Google Scholar 

  37. Frazier OH, Gemmato C, Myers TJ, et al. Initial clinical experience with the HeartMate II axial-flow left ventricular assist device. Tex Heart Inst J. 2007;34(3):275–81.

    PubMed  CAS  Google Scholar 

  38. Miller LW, Pagani FD, Russell SD, et al. HeartMate II clinical investigators. Use of a continuous-flow device in patients awaiting heart transplantation. N Engl J Med. 2007;357(9):885–96.

    Article  PubMed  CAS  Google Scholar 

  39. Pagani FD, Miller LW, Russell SD, et al. Extended mechanical circulatory support with a continuous flow rotary left ventricular assist device. J Am Coll Cardiol. 2009;54(9):312–21.

    Article  PubMed  Google Scholar 

  40. Frazier OH, Gregoric ID, Cohn WE. Initial experience with non-thoracic, extraperitoneal, off-pump insertion of the Jarvik 2000 Heart in patients with previous median sternotomy. J Heart Lung Transplant. 2006;25(5):499–503.

    Article  PubMed  CAS  Google Scholar 

  41. Frazier OH, Shah NA, Myers TJ, et al. Use of the Flowmaker (Jarvik 2000) left ventricular assist device for destination therapy and bridging to transplantation. Cardiology. 2004;101(1–3):111–6.

    Article  PubMed  CAS  Google Scholar 

  42. Siegenthaler MP, Frazier OH, Beyersdorf F, et al. Mechanical reliability of the Jarvik 2000 Heart. Ann Thorac Surg. 2006;81(5):1752–9.

    Article  PubMed  Google Scholar 

  43. Farrar DJ, Bourque K, Dague CP, et al. Design features, developmental status, and experimental results with the Heartmate III centrifugal left ventricular assist system with a magnetically levitated rotor. ASAIO J. 2007;53(3):310–5.

    Article  PubMed  Google Scholar 

  44. Bourque K, Gernes DB, Loree HM, et al. HeartMate III: pump design for a centrifugal LVAD with a magnetically levitated rotor. ASAIO J. 2001;47(4):401–5.

    Article  PubMed  CAS  Google Scholar 

  45. Wood C, Maiorana A, Larbalestier R, et al. First successful bridge to myocardial recovery with a HeartWare HVAD. J Heart Lung Transplant. 2008;27(6):695–7.

    Article  PubMed  Google Scholar 

  46. Tuzun E, Roberts K, Cohn WE, et al. In vivo evaluation of the HeartWare centrifugal ventricular assist device. Tex Heart Inst J. 2007;34(4):406–11.

    PubMed  Google Scholar 

  47. Morley D, Litwak K, Ferber P, et al. Hemodynamic effects of partial ventricular support in chronic heart failure: results of simulation validated with in vivo data. J Thorac Cardiovasc Surg. 2007;133(1):21–8.

    Article  PubMed  Google Scholar 

  48. Chang JC, Sawa Y, Ohtake S, et al. Hemodynamic effect of inhaled nitric oxide in dilated cardiomyopathy patients on LVAD support. ASAIO J. 1997;43:M418–21.

    Article  PubMed  CAS  Google Scholar 

  49. Salamonsen RF, Kaye D, Esmore DS. Inhalation of nitric oxide provides selective pulmonary vasodilatation, aiding mechanical cardiac assist with thoratec left ventricular assist device. Anaesth Intensive Care. 1994;22:209–10.

    PubMed  CAS  Google Scholar 

  50. Argenziano M, Choudhri AF, Oz MC, et al. A prospective randomized trial of arginine vasopressin in the treatment of vasodilatory shock after left ventricular assist device placement. Circulation. 1997;96:II90.

    Google Scholar 

  51. Pennock JL, Pierce WS, Wisman CB, et al. Survival and complications following ventricular assist pumping for cardiogenic shock. Ann Surg. 1983;198:469–78.

    Article  PubMed  CAS  Google Scholar 

  52. Morgan JA, Park Y, Oz MC, et al. Device-related infections while on LVAD support do not adversely impact bridging to transplant or post-transplant survival. ASAIO J. 2003;49(6):748–50.

    Article  PubMed  Google Scholar 

  53. Morgan JA, Oz MC. Cost-effectiveness of ventricular assist devices. Expert Rev Pharmacoecon Outcomes Res. 2003;3(4):427–32.

    Article  PubMed  Google Scholar 

  54. DiGiorgi PL, Reel MS, Thornton B, et al. Heart transplant and left ventricular assist device costs. J Heart Lung Transplant. 2005;24(2):200–4.

    Article  PubMed  Google Scholar 

  55. Rose EA, Levin HR, Oz MC, et al. Artificial circulatory support with textured interior surfaces. A counterintuitive approach to minimizing thromboembolism. Circulation. 1994;90:II87–91.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Cardiothoracic Surgery, Henry Ford Hospital, 2799 W. Grand Blvd., K-14, Rm. 1439, Detroit, MI, 48202, USA

    Jeffrey A. Morgan M.D.

  2. Department of Cardiothoracic Surgery, New York Presbyterian Hospital, 177 Fort Washington Ave., Milstein 7GN-435, New York, NY, 10032, USA

    Yoshifumi Naka M.D., Ph.D.

Authors
  1. Jeffrey A. Morgan M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yoshifumi Naka M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jeffrey A. Morgan M.D. .

Editor information

Editors and Affiliations

  1. Division of Cardiothoracic Surgery, Henry Ford Hospital, West Grand Blvd. 2799, Detroit, 48202, Michigan, USA

    Jeffrey A. Morgan

  2. Department of Cardiothoracic Surgery, New York Presbyterian Hospital, Fort Washington Avenue 177, New York, 10032, New York, USA

    Yoshifumi Naka

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Science+Business Media New York

About this chapter

Cite this chapter

Morgan, J.A., Naka, Y. (2013). Mechanical Circulatory Support as a Bridge to Transplantation. In: Morgan, J., Naka, Y. (eds) Surgical Treatment for Advanced Heart Failure. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6919-3_10

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-6919-3_10

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-6918-6

  • Online ISBN: 978-1-4614-6919-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation