ROLE OF AN ABIOMED FOR SHORT-TERM SUPPORT AND BRIDGE TO TRANSPLANTATION

Abstract

Purpose: Although HeartMate (ThermoCardiosystems Inc, Woburn, MA) is our preferred device for bridge to transplantation, we have gained experience using the ABIOMED (Danvers, MA) device for short-term mechanical support as well as a bridge to transplant in select patients. We retrospectively reviewed our 8-year experience with the ABIOMED device. Methods: From May 1994 to September 2002, 53 ABIOMED devices were implanted for short-term support in bridge-to-transplant patients. These included 16 LVADs, 21 RVADs, and 16 BIVADs. Mean age was 54±19 years for LVADs, 53±11 years for RVADs, and 40±23 years for BIVADs. Etiology of heart failure was CAD in 70% (36), ICM in 20% (10), and other in 10% (7). Duration of support was 4.8±3.5 (0–11) days for LVADs, 5.9±4.5 (0–17) days for RVADs, and 5.1±5.1 (0–20) for BIVADs. Survival while on support, successful bridging to transplantation, and post-transplant survival was calculated for each ABIOMED device. Results: Survival on support was 87.5% (14) for LVADs, 57.1% (12) for RVADs, and 50.0% (8) for BIVADs. Complete weaning was accomplished in 25.0% (4) of LVADs, 14.3% (3) of RVADs, and 12.5% (2) of BIVADs. Bridging to transplantation occurred in 12.5% (2) LVADs, 38.1% (8) RVADs, and 18.8% (3) BIVADs. Overall post-transplant 5-year survival was 64.5%; 66.7% for LVADs, 60.0% for RVADs and 66.7% for BIVADs. These results indicate that the ABIOMED can be used effectively for short-term stabilization and bridging-to-transplant in select patients.