TY - JOUR
T1 - Heterotopic Prosthetic Ventricles as a Bridge to Cardiac Transplantation
AU - Farrar, David J.
AU - Hill, J. Donald
AU - Gray, Laman A.
AU - Pennington, D. Glenn
AU - McBride, Lawrence R.
AU - Pierce, William S.
AU - Pae, Walter
AU - Glenville, Brian
AU - Ross, Donald
AU - Galbraith, Timothy A.
AU - Zumbro, G. Lionel
PY - 1988/2/11
Y1 - 1988/2/11
N2 - Heterotopic prosthetic ventricles were used to support the circulation in 29 candidates for heart transplantation who were expected to die before procurement of a donor heart. Twenty-one of these patients (average age, 36 years) underwent successful transplantation after 8 hours to 31 days of circulatory support. The other eight patients died because their condition could not be stabilized for transplantation, despite restoration of blood flow. Fourteen patients received biventricular support; 15 received only left ventricular support, with pharmacologic assistance of right heart function. Before transplantation, blood flow from the left prosthetic ventricle averaged 2.8±0.4 liters per minute per square meter of body-surface area, and from the right prosthesis 2.4±0.4 liters, as compared with an average flow of 1.6±0.5 liters per minute per square meter before implantation. Of the 21 patients who received heart transplants, 20 were discharged from the hospital after a median of 31 days. Nineteen patients were alive at 7 to 39 months, and 11 of the first 12 were alive at one year. We conclude that heterotopic placement of prosthetic ventricles as a bridge to transplantation provides an effective method of temporarily supporting cardiac function in critically ill patients without removing the natural heart. The early survival rate after transplantation is similar to that with elective cardiac transplantation. (N Engl J Med 1988; 318:333–40.)
AB - Heterotopic prosthetic ventricles were used to support the circulation in 29 candidates for heart transplantation who were expected to die before procurement of a donor heart. Twenty-one of these patients (average age, 36 years) underwent successful transplantation after 8 hours to 31 days of circulatory support. The other eight patients died because their condition could not be stabilized for transplantation, despite restoration of blood flow. Fourteen patients received biventricular support; 15 received only left ventricular support, with pharmacologic assistance of right heart function. Before transplantation, blood flow from the left prosthetic ventricle averaged 2.8±0.4 liters per minute per square meter of body-surface area, and from the right prosthesis 2.4±0.4 liters, as compared with an average flow of 1.6±0.5 liters per minute per square meter before implantation. Of the 21 patients who received heart transplants, 20 were discharged from the hospital after a median of 31 days. Nineteen patients were alive at 7 to 39 months, and 11 of the first 12 were alive at one year. We conclude that heterotopic placement of prosthetic ventricles as a bridge to transplantation provides an effective method of temporarily supporting cardiac function in critically ill patients without removing the natural heart. The early survival rate after transplantation is similar to that with elective cardiac transplantation. (N Engl J Med 1988; 318:333–40.)
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U2 - 10.1056/NEJM198802113180601
DO - 10.1056/NEJM198802113180601
M3 - Article
C2 - 3277051
AN - SCOPUS:0023841132
SN - 0028-4793
VL - 318
SP - 333
EP - 340
JO - New England Journal of Medicine
JF - New England Journal of Medicine
IS - 6
ER -