Objectives: Left ventricular assist devices (LVAD), used in the setting bridge-to-transplantation and destination therapy, for patients with deteriorating severe heart failure are continuously developing. The second generation, the axial flow pumps, have been introduced since some years.
Design: Eleven consecutive patients, seven male, with severe heart failure due to ischemic cardiomyopathy (n=5), dilated cardiomyopathy (n=5) and cytotoxic etiology (n=1) were implanted with the HeartMate-II. They were preoperatively treated with inotropic support (n=9), ventricular assist device (n=2) and mechanical ventilation (n=4).
Results: Eight patients were bridged to transplant after median 155 days (range, 65 to 316 days). One patient is ongoing for 748 days, intended for destination therapy. Ten of eleven patients were discharged after median 64 days (range, 40 to 105 days). Four patients were reoperated due to bleeding. Two embolic events were recorded. One perioperative death.
Conclusion: Eleven HM-II LVAD's have been implanted in our institution with good early results. Eight patients were successfully bridged to heart transplantation. One patient is intended for destination therapy and is ongoing since November 2006. In these severely ill patients, this technique offers a good chance surviving until heart transplantation. In selected cases the technique also offers the possibility of a permanent support and longevity.