Mechanical Cardiac Support – The First Use in Czech Republic

Overview

Background.
Implantation of mechanical assist device is widely accepted modality of treatment of patients with refractory heart failure. In the present study we evaluated our first one-year experiences with this method for bridging patients to cardiac transplantation. 

Methods and Results.
Between April 2003 and May 2004, the Thoratec^® VAD (Thoratec, Pleasanton, CA, USA) was implanted in 6 patients ( males; age 28–61 years) as a bridge-to-transplant procedure after having received maximum inotropic support and who were at imminent risk of death. In all patients was performed VAD as biventricular device (BiVAD).

During a week after placement was observed recovery of organs function in all patients. Five patients survived to heart transplantation. One patient died 21 days after BiVAD placement due to massive bleeding to the respiratory tract. In post-transplantation period 1 patient died second day from acute graft failure and other patient died 34 days after from intracranial bleeding. Three patients has been discharged from the hospital and they are surviving more than 1 year. 

Conclusions.
Analysis of our first experiences with the Thoratec BiVAD implantation as bridging to heart transplantation suggests that it is well suited method with respect to long- term prognosis of this group of patients. 

Key words:
heart failure, mechanical assist devices, heart transplantation.