LONG TERM SUPPORT BY USING EXTRACORPOREAL LEFT VENTRICULAR ASSIST SYSTEM

Abstract

Left ventricular assist system (LVAS) is effective therapeutic option for severe heart failure patients. From 1994, we applied an extracorporeal pneumatic Toyobo-LVAS to 41 patients (male: 28, female: 13, age: 8–57 (mean: 34) years old) with acute deterioration of chronic heart failure. Of those, 37 were dilated cardiomyopathy, the other were ischemic cardio-myopathy. Initially, we applied left atrial drainage type system (LA-LVAS). From 1499, we introduced left ventricular drainage system (LV-LVAS). LA-LVAS was applied in 10 patients, LV-LVAS in 26, and biventricular support in the other. Supporting duration was 7–767 (249) days. Of those, seven were transplanted after 39–669 (330) days' supports. All transplanted patients except one are doing well up to 2.7 years after transplant. Six were weaned from LVAS after 90–146 (120) days supports and 5 of them are doing well up to 6 years after removal. Eighteen were died on LVAS after 7–475 (174) days' supports and 10 of them were candidates for heart transplantation. Causes of deaths were infection in 8 and cerebral damage in Y and arrhythmia in 1. The other 10 patients are on-going for 10–767 (387) days to wait heart transplantation. In comparison between LA-LVAS and LV-LVAS, mean supporting period in LV-LVAS is longer than that in LA-LVAS (165 days vs. 384 days). From our data, Toyobo-LVAS, especially LV-LVAS, is useful for long-term support for waiting for heart transplant or myocardial recovery.