9. Clinical Experience with 104 Thoratec Ventricular Assist Devices

Lawrence R. McBride, Renato Ruggiero, Debbie A. Moroney, Karen A. Powers, Marc T. Swartz

Saint Louis University

St. Louis, Mo.

Background: Ventricular assist devices (VADs) have gained wider clinical acceptance due to refinements in patient selection and management and device availability.

Methods: To evaluate early and late results we reviewed our first 104 patients with the Thoratec VAD.

Results: Forty-three patients were supported for recovery. The mean age in the recovery group was 52.1 years. There were 17 left VADs (LVADs), 17 biventricular VADs (BVADs), and nine right VADS. Complications included bleeding/13 patients (30 percent) and device-related infection/one pt (2 percent). Sixty-one patients were supported as a bridge to transplant. The mean age was 41.7 years. There were 35 LVADs and 26 BVADs. Complications included bleeding/16 patients (26 percent), device-related infection/eight patients (13 percent). Device-related thromboembolism occurred in seven patients (6.7 percent, six bridge, one recovery).
 

Twelve-year actuarial survival was 9 percent for the recovery group, 22 percent for the bridge group with transplanted patients having a 12-year actuarial survival rate of 33 percent. Overall actuarial survival at 12 years was 17 percent.

Conclusions: Despite advances, VAD support remains associated with significant morbidity and poor long-term survival. Recovery results may improve as better techniques and technology evolve.