Advertisement
Heart, Lung and Circulation
Advanced searchSave search
Original article| Volume 3, ISSUE 1, P17-24, July 1994

Bridging to cardiac transplantation with the novacor left ventricular assist system

DOI:https://doi.org/10.1016/1324-2881(94)90051-5
Bridging to cardiac transplantation with the novacor left ventricular assist system
Previous ArticleDefinition and function of commissures, slits and scallops of the mitral valve: Analysis in 100 hearts
Next ArticleEthical principles for surgeons
      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      The Novacor left ventricular assist system (LVAS) has been used as a bridge to cardiac transplantation in 22 patients at Stanford University since September 1984. All patients were in hospital receiving inotropic support for severe biventricular failure. Nine were supported by an intra-aortic balloon pump, 17 had pulmonary oedema, seven had life-threatening ventricular arrhythmias, 10 had liver dysfunction with coagulopathy, and seven had renal dysfunction. Prior to implantation the mean cardiac index was 1.6 L/min/m2, which rose to 3.3 L/min/m2 following device insertion. Two patients died during implantation, and four died from multiorgan failure after device implantation. The majority of patients who had been supported for more than 1 week were ambulatory while awaiting transplantation. One patient received the recently developed system with a wearable battery/controller. Sixteen patients (73%) underwent successful cardiac transplantation after a mean of 21 days support. One patient died of sepsis, and another died of malignancy following transplantation. Fourteen patients (88%) were alive 1 month to 9 years after transplantation. Worldwide, as of November 1993, 176 patients have had the Novacor LVAS implanted (including 17 with the wearable system). Twelve were still being supported, 101(60%) had received a transplant, and 92 (91%) of these were discharged from hospital. There were 82 (89%) survivors at a mean of 30 months post-transplantation. No episodes of device failure have occurred. The post-transplant survival in this group of patients bridged to transplantation was similar to those having routine transplantation. The wearable system has provided greater patient freedom. Future development will be towards a totally implantable LVAS.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Heart, Lung and Circulation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Register: Create an account
      Institutional Access: Sign in to ScienceDirect

      References

        • Starves V.A.
        • Oyer P.E.
        • Portner P.M.
        • et al.
        Isolated left ventricular assist as a bridge to cardiac transplantation.
        J Thorac Cardiovasc Surg. 1988; 96: 62-71
        • Portner P.M.
        • Oyer P.E.
        • Pennington D.G.
        • et al.
        Implantable electrical left ventricular assist system: bridge to transplantation and the future.
        Ann Thorac Surg. 1989; 47: 142-150
        • McCarthy P.M.
        • Portner P.M.
        • Tobler H.G.
        • Stames V.A.
        • Ramasamy N.
        • Oyer P.E.
        Clinical experience with the Novacor ventricular assist system. Bridge to transplantation and the transition to permanent application.
        J Thorac Cardiovasc Surg. 1991; 102: 578-587
        • Smith J.A.
        • Oyer P.E.
        Development of the Novacor left ventricular assist system.
        in: Shumway S.J. Shumway N.E. Thoracic Transplantation. Blackwell Scientific Publications, Boston1994 (in press)
        • Kaye M.P.
        The Registry of the International Society for Heart and Lung Transplantation: tenth official report, 1993.
        J Heart Lung Transplant. 1993; 12: 541-548
        • Report to the Chairman
        • Subcommittee on Health
        • Committee on Ways and Means
        • US House of Representatives
        Heart transplants: concerns about cost, access, and availability of donor organs.
        US General Accounting Office, Washington1989
        • Loisance D.Y.
        • Dubois Rande J.L.
        • Deleuze P.H.
        • et al.
        Pharmacological bridge to cardiac transplantation.
        Eur J Cardiothorac Surg. 1989; 3: 196-202
        • Loisance D.Y.
        • Deleuze P.H.
        • Housl R.
        • et al.
        Pharmacological bridge to cardiac transplantation: Current limitations.
        Ann Thorac Surg. 1993; 55: 310-313
        • Golding L.A.R.
        • Stewart R.W.
        • Sinkewich M.
        • Smith W.
        • Cosgrove D.M.
        Nonpulsatile ventricular assist bridging to transplantation.
        Trans Am Soc Artif Intern Organs. 1988; 34: 476-479
        • Bolman III, R.M.
        • Cox J.L.
        • Marshall W.
        • et al.
        Circulatory support with a centrifugal pump as a bridge to cardiac transplantation.
        Ann Thorac Surg. 1989; 47: 108-112
        • Magovern G.J.
        The biopump and postoperative circulatory support.
        Ann Thorac Surg. 1993; 55: 245-249
        • Roberts C.P.
        • Wildman D.
        • Woolhouse K.
        • et al.
        Left ventricular assist with the Bio-Medicus in a four-month-old infant with anomalous left coronary artery.
        J Extracorp Technol. 1989; 21: 73-74
        • Pennington D.G.
        • Swartz M.T.
        Circulatory support in infants and children.
        Ann Thorac Surg. 1993; 55: 233-237
        • Farrar D.J.
        • Hill J.D.
        Univentricular and biventricular Thoratec VAD support as a bridge to transplantation.
        Ann Thorac Surg. 1993; 55: 276-282
        • Smith J.A.
        • Rabinov M.
        • Anderson J.
        • et al.
        Initial Australian experience with the Thoratec ventricular assist device.
        AustralAs J Cardiac Thorac Surg. 1992; 1: 37-43
        • Muneretto C.
        • Solis E.
        • Pavie A.
        • et al.
        Total artificial heart: survival and complications.
        Ann Thorac Surg. 1989; 47: 151-157
        • Griffith B.P.
        Interim use of the Jarvik-7 artificial heart: lessons learned at Presbyterian-University Hospital of Pittsburgh.
        Ann Thorac Surg. 1989; 47: 158-166
        • Copeland J.G.
        • Smith R.
        • Icenogle T.
        • et al.
        Orthotopic total artificial heart bridge to transplantation: preliminary results.
        J Heart Transplant. 1989; 8: 124-138
        • Gristina A.G.
        • Dobbins J.J.
        • Giammara B.
        • Lewis J.C.
        • DeVries W.C.
        Biomaterial-centered sepsis and the total artificial heart.
        JAMA. 1988; 259: 870-874
        • Smith J.A.
        • Salamonsen R.F.
        • Rosenfeldt F.L.
        • Esmore D.S.
        Initial experience with the Haemopump left ventricular assist device.
        Aust NZ J Surg. 1991; 61: 271-275
        • Frazier O.H.
        • Duncan J.M.
        • Parnis S.M.
        • Igo S.R.
        • Fuqua J.M.
        Circulatory support following cardiac transplantation.
        J Heart Transplant. 1990; 9: 58
        • Reedy J.E.
        • Swartz M.T.
        • Termuhlen D.F.
        • et al.
        Bridging to heart transplantation: importance of patient selection.
        J Heart Transplant. 1990; 9: 473-481
        • Pennington D.G.
        • Farrar D.J.
        • Loisance D.Y.
        • Pae W.E.
        • Emery R.W.
        Panel 1. Patient selection.
        Ann Thorac Surg. 1993; 55: 206-212
        • Pifarre R.
        • Sullivan H.
        • Montoya A.
        • et al.
        Comparison of results after heart transplantation: mechanically supported versus non-supported patients.
        J Heart Lung Transplant. 1992; 11: 235-239

      Article info

      Identification

      DOI: https://doi.org/10.1016/1324-2881(94)90051-5

      Copyright

      © 1994 Published by Elsevier Inc.

      ScienceDirect

      Access this article on ScienceDirect

      The content on this site is intended for healthcare professionals.


      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the Cookie Preference Center for this site.
      Copyright © 2023 Elsevier Inc. except certain content provided by third parties.


      RELX