243 Comparison of Outcomes for Heart Transplantation Following Continuous Versus Pulsatile Flow Ventricular Assist Device Bridging

Abstract

the treatment of chronic heart failure(CHF) is worldwide tremendously increasing. Therefore, we analyzed the outcome of patients suffering from end-stage-CHF in whom a LVAD(HeartWare-HVAD) was implanted with a newly developed surgical technique. Methods and Materials: Between April,2011 and November,2011 we retrospectively analyzed the data of 19 patients who were operated at our institution with a novel, minimized approach:first, using cardiopulmonary bypass, LVAD pump was inserted through anterolateral thoracotomy and secondly, LVAD-outflowgraft was anastomosed end-to-side to the ascending-aorta through upper-hemisternotomy. Results: In 19 patients a novel, minimized approach for LVAD implantation was used. Mean age of the patient population (17men/2women) was 51.1 13years(range:19-74years). Etiology of heart failure was widely distributed (DCM-10,ICM-6,toxic-CM-1,postpartal-CM-1,Myocarditis-1). One patient died within the first 30days(1/13),none of the patients revealed wound infections(0/19),only one patient right ventricular assist device implantation(RVAD) became necessary to treat the occurrence of perioperative right heart failure(1/19). Finally,all surviving patients(100%) were successfully discharged to rehabilitation-centre. Conclusions: Surgical implantation of centrifugal pumps through this novel, minimized approach is proven to be feasible and associated with several positive effects. Surgical trauma is minimized which leads to reduced complication rates; the pericardium remains closed which protects the RV against over-dilation. In summary, 30-day-mortality for this high risk patient collection remains very low.