Ventricular assist devices can be used as bridge to heart recovery without need for heart transplant

NEW ORLEANS, Nov. 9 - A heart ventricular assist device (VAD) is used as a bridge to organ transplantation, maintaining a patient's cardiac function until a donor organ becomes available. In some cases, the device rests the heart and allows it to heal without the need for heart transplantation. The frequency of this occurrence and the patients most likely to benefit from VAD as a bridge to heart recovery remains poorly defined.

In a study presented today at the American Heart Association's Scientific Sessions 2004 in New Orleans, Marc A. Simon, M.D., fellow in transplantation cardiology at the University of Pittsburgh School of Medicine, reported on the long-term outcome of patients successfully weaned from VADs at the University of Pittsburgh Medical Center (UPMC).

"We found that seven percent of patients implanted with heart assist devices were successfully weaned from the devices without the need for a heart transplant," said Dr. Simon. "Our study found that when utilized in acute inflammatory cardiomyopathy or post-partum cardiomyopathy (PPCM), VAD support appears to allow long-term restoration of cardiac function. VAD support as a bridge to recovery (BTR) should be an important component of the care of acute inflammatory myocarditis."

The study included 147 patients who underwent VAD implantation at UPMC from 1996 through 2003. Of the patients, 70 were ischemic and 77 non-ischemic. Of these, 10 were weaned from VAD as a BTR.

They included two ischemic patients who needed heart bypass surgery following heart attacks and required postoperative VAD support. Both remain alive and transplant free.

A larger number of non-ischemic patients, eight, underwent successful BTR. Five received biventricular assist devices; three had a clinical course consistent with acute myocarditis; four had PPCM; and one had chronic non-ischemic cardiomyopathy with decompensation in the setting of active pulmonary tuberculosis, which was successf


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