Mechanical circulatory assistance after heart transplantation

Robert W. Emery, Frazier Eales, Lyle D. Joyce, Thomas J. Von Rueden, R. Michael King, Charles R. Jorgensen, Marc R. Pritzker, Kristen E. Johnson, Kathleen D. Lake, Kit V. Arom

Research output: Contribution to journalArticlepeer-review

29 Scopus citations

Abstract

From October 1985 through December 1989, 92 heart transplant procedures were performed in 89 patients. Nine patients (aged 19 to 66 years; 7 male, 2 female) required mechanical circulatory support after transplantation because of primary idiopathic organ failure (n = 2), implant difficulty (2), poor organ quality (2), or acute right heart failure (3). Devices used included the intraaortic balloon pump (6), centrifugal right ventricular assist device (2), left ventricular assist (1), biventricular assists (2), and total artificial heart (1). Two patients required multiple devices. One patient underwent retransplantation. Implant time ranged from 1 to 18 days. One early death occurred owing to right heart failure 6 days after transplantation, 7 hours after removal of a right ventricular assist device, for an overall mortality of 11%. The remaining 8 patients are alive 4 months to 28 months after transplantation. The actuarial 1-year survival of 89% ± 10% compares well with the survival of 87% ± 4% for the entire transplant group. All surviving patients are in functional class I. Echocardiographic examination in all patients revealed left ventricular ejection fraction to be normal in 7 and depressed in 1. Extending the criteria for organ donors or difficulty with the implant procedure can lead to early organ failure, which may be reversible with circulatory assistance allowing excellent survival.

Original languageEnglish (US)
Pages (from-to)43-47
Number of pages5
JournalThe Annals of thoracic surgery
Volume51
Issue number1
DOIs
StatePublished - Jan 1991

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