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J Thorac Cardiovasc Surg 2003;125:228-230
© 2003 The American Association for Thoracic Surgery

Editorials

Multicenter bridge to transplantation with the HeartMate assist device: Evaluation from another perspective

From the Department of Cardiothoracic Surgery, The University of Arizona Health Science Center, Tucson, Ariz.

Received for publication July 5, 2001. Accepted for publication Aug 15, 2002. Address for reprints: Jack G. Copeland, MD, Department of Cardiothoracic Surgery, The University of Arizona Health Science Center, PO Box 245071, Tucson, AZ 85724 (E-mail: jgc@u.arizona.edu).

The first 300 words of the full text of this article appear below.

See related articles on pages 227 and 440.

Bridge to transplantation has been a scenario for the use of a variety of mechanical support devices since the mid-1980s. Nearly every device studied led to survival to transplantation in the range of 60% to 70% and survival to discharge after transplantation of 50% to 60% of the total population. Selection has not been standardized, but in general the patient population, in the absence of device support, has been at very high risk. Several thousand lives have been saved, and much experience has been gained in the use of artificial hearts, left ventricular assist devices (LVADs), and biventricular assist devices (BiVADs). This experience will lead to future use of mechanical support devices as permanent definitive therapy for a population of patients with heart failure in the United States that has most often been estimated to be in the range of 30,000 to 60,000 patients per year. Definitive use of device support is underway in small numbers of patients and appears very promising. Bridge to transplant studies such as the report by Frazier and associates ¹ in this Journal are therefore of vital concern to the thoracic surgery community.

The report by Frazier and colleagues ¹ of 280 implants of the HeartMate vented electric LVAD (Thermo Cardiosystems, Inc, Woburn, Mass) at 24 centers in the United States represents a major effort by a group of excellent surgeons. It documents that, of the total number of patients, 67% survived to transplantation and 56% (84% of those undergoing transplantation) lived for at least 1 year after transplantation compared with 33% survival to transplant and 21% (63% of those transplanted) survival for 1 year after transplantation in a group of 48 matched historical controls. "Outpatient enrollment" for implanted patients was 70% (160 patients) and "full outpatient status" . . . [Full Text of this Article]

Related Articles

Editor's introduction

Andrew S. Wechsler
J. Thorac. Cardiovasc. Surg. 2003 125: 227. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				O. H. Frazier Multicenter bridge to transplantation with the HeartMate assist device: Evaluation from another perspective. A rebuttal J. Thorac. Cardiovasc. Surg., February 1, 2003; 125(2): 440 - 441. [Full Text] [PDF]