Clinical experience with long-term use of implantable left ventricular assist devices: indications, implantation, and outcomes.

V. Kasirajan*, P. M. McCarthy, K. J. Hoercher, R. C. Starling, J. B. Young, M. K. Banbury, N. G. Smedira

*Corresponding author for this work

Research output: Contribution to journalArticle

41 Scopus citations

Abstract

We describe our clinical experience with 205 implantable left ventricular assist devices at the Cleveland Clinic between December 1991 and January 2000, along with manufacturers' data submitted to the Food and Drug Administration. In patients with end-stage cardiac failure who are suitable candidates for transplantation, these devices serve as excellent bridges to transplantation. Recent modifications have increased pump reliability and reduced thromboembolic rates. The vented electric HeartMate (Thermocardiosystems Inc, Woburn, MA) and the Novacor (Baxter-Novacor, Oakland, CA) left ventricular assist systems allow patients to be discharged from the hospital while awaiting a donor heart. Experience with long-term support is providing insights into permanent implantation of these devices as destination therapy. Although infection remains a major impediment to long-term support, patient-pump interactions leading to changes in the coagulation and immune systems are being recognized, and these interactions may have important implications with respect to thromboembolism, infection, and sensitization to human leukocyte antigens (HLAs). Better understanding of these factors may eventually lead to the development of permanently implantable pumps as an alternative to transplantation.

Original languageEnglish (US)
Pages (from-to)229-237
Number of pages9
JournalSeminars in Thoracic and Cardiovascular Surgery
Volume12
Issue number3
DOIs
StatePublished - Jan 1 2000

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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