Hemodynamic and physiologic changes during support with an implantable left ventricular assist device

Patrick M. McCarthy*, Robert M. Savage, Charles D. Fraser, Rita Vargo, Karen B. James, Marlene Goormastic, Robert E. Hobbs

*Corresponding author for this work

Research output: Contribution to journalArticle

70 Scopus citations

Abstract

To evaluate hemodynamic effectiveness and physiologic changes on the HeartMate 1000 IP left ventricular assist device (Thermo Cardiosystems, Inc., Woburn, Mass.), we studied 25 patients undergoing bridge to heart transplantation (35 to 63 years old, mean 50 years). All were receiving inotropic agents before left ventricular assist device implantation, 21 (84%) were supported with a balloon pump, and 7 (28%) were supported by extracorporeal membrane oxygenation. Six patients died, primarily of right ventricular dysfunction and multiple organ failure. Nineteen (76%) were rehabilitated, received a donor heart, and were discharged (100% survival after transplantation). Pretransplantation duration of support averaged 76 days (22 to 153 days). No thromboembolic events occurred in more than 1500 patient-days of support with only antiplatelet medications. Significant hemodynamic improvement was measured (before implantation to before explantation) in cardiac index (1.7 ± 0.3 to 3.1 ± 0.8 L/min per square meter; P < 0.001), left atrial pressure (23.7 ± 7 to 9 ± 7.5mm Hg; p < 0.001), pulmonary artery pressure, pulmonary vascular resistance, and right ventricular volumes and ejection fraction. Both creatinine and blood urea nitrogen levels were significantly higher before implantation in patients who died while receiving support. Renal and liver function returned to normal before transplantation. We conclude that support with the HeartMate device improved hemodynamic and subsystem function before transplantation. Long-term support with the HeartMate device a realistic alternative to medical therapy. (J THORAC CARDIOVASC SURG 1995; 109: 409-18).

Original languageEnglish (US)
Pages (from-to)409-418
Number of pages10
JournalThe Journal of Thoracic and Cardiovascular Surgery
Volume109
Issue number3
DOIs
StatePublished - Mar 1995

ASJC Scopus subject areas

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

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