Gultekin Bahadir, Ersoy Ozgur, Ozkan Murat, Akkaya Ilknur, Umaroglu Sevi, Sezgin Atilla
From the Department of Cardiovascular Surgery, Baskent University Faculty of Medicine, Ankara, Turkey 06490.
Exp Clin Transplant. 2015 Nov;13 Suppl 3:149-52. doi: 10.6002/ect.tdtd2015.P80.
The number of patients with end-stage cardiac failure who are waiting for transplant has been increasing, although number of heart donations stays limited. This has resulted in an increased use of left ventricular assist devices. Here, we present results of patients who received left ventricular assist device implants at Baskent University Ankara Hospital.
We retrospectively evaluated 24 patients who received a HeartWare left ventricular assist device (HeartWare Inc, Framingham, MA, USA) between April 2012 and February 2015; 2 patients (8.33%) were female.
Patients had end-stage heart failure as a result of the following causes: 11 patients (45%) had ischemic cardiomyopathy, 12 patients (50%) had dilated cardiomyopathy, and 1 patient (4.1%) had acute myocarditis. Regarding use of the left ventricular assist device, 10 patients (41.6%) had the device as destination therapy, and the remaining 14 patients (48.6%) had it as bridge to transplant. The Interagency Registry for Mechanically Assisted Circulatory Support Profile was 1 for 3 patients (12.5%), 2 for 9 patients (37.5%), and 3 for 12 patients (50%). Mean follow-up was 239.8 days, and the mortality rate was 33.3% (8 patients died). During follow-up, we found that 3 patients (12.5%) had received a heart transplant and 1 patient (4.1%) eventually recovered, with the device extracted. Six patients had driveline infections, and 3 patients had cerebrovascular events.
With the insufficient number of cardiac donors, use of a left ventricular assist device for patients with end-stage cardiac failure who are awaiting transplant may be the best option.
尽管心脏捐赠数量仍然有限，但等待心脏移植的终末期心力衰竭患者数量一直在增加。这导致左心室辅助装置的使用增多。在此，我们展示在安卡拉巴斯肯大学医院接受左心室辅助装置植入的患者的结果。
我们回顾性评估了2012年4月至2015年2月期间接受HeartWare左心室辅助装置（美国马萨诸塞州弗雷明汉市HeartWare公司）的24例患者；2例患者（8.３３％）为女性。
患者因以下原因导致终末期心力衰竭：11例患者（45％）患有缺血性心肌病，12例患者（50％）患有扩张型心肌病，1例患者（4.1％）患有急性心肌炎。关于左心室辅助装置的使用，10例患者（41.6％）将该装置作为目标治疗，其余14例患者（48.6％）将其作为移植过渡。机构间机械辅助循环支持概况登记中，3例患者（12.5％）评分为1，9例患者（37.5％）评分为2，12例患者（50％）评分为3。平均随访时间为239.8天，死亡率为33.3％（8例患者死亡）。随访期间，我们发现有3例患者（12.5％）接受了心脏移植，1例患者（4.1％）最终康复并取出了装置。6例患者发生了导线感染，3例患者发生了脑血管事件。
由于心脏供体数量不足，对于等待移植的终末期心力衰竭患者，使用左心室辅助装置可能是最佳选择。
