A prospective, multicenter trial of the VentrAssist left ventricular assist device for bridge to transplant: Safety and efficacy

被引:57
作者
Esmore, Donald [1 ]
Kaye, David [1 ]
Spratt, Phillip [2 ]
Larbalestier, Robert [3 ]
Ruygrok, Peter [4 ]
Tsui, Steven [5 ]
Meyers, Deborah [6 ]
Fiane, Arnt E. [7 ]
Woodard, John [8 ]
机构
[1] Monash Univ, Alfred Hosp, Melbourne, Vic 3181, Australia
[2] St Vincents Hosp, Sydney, NSW 2010, Australia
[3] Royal Perth Hosp, Perth, WA, Australia
[4] Auckland City Hosp, Auckland, New Zealand
[5] Papworth Hosp, Cambridge CB3 8RE, England
[6] Prince Charles Hosp, Brisbane, Qld 4032, Australia
[7] Rikshosp Univ Hosp, Oslo, Norway
[8] Ventracor Ltd, Sydney, NSW, Australia
关键词
D O I
10.1016/j.healun.2008.02.012
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The increasing prevalence of chronic heart failure has stimulated the ongoing development of left ventricular assist devices. (LVADs) for both bridge-to-transplant (13717) and destination therapy (DT). The aim of this prospective, Multicenter clinical trial was to determine the efficacy and safety of a third-generation LVAD, the VentrAssist, in a BTT cohort. Methods: Patients (n = 33) with end-stage chronic heart failure who required, circulatory support as BTT therapy were implanted with a VentrAssist device. The. primary outcome was survival until transplant or transplant eligibility with the device in situ at trial end-point (Day 154 after implant). The secondary outcomes were pump flow index and end-organ function. Safety, patient functional status and resource use were also assessed. Results: At trial end-point, the success rate was 82% (39.4% transplanted, 42.4% transplant-eligible). The LVAD pump flow index (median >= 2-7 liters/min/m(2)) was sufficient to maintain an adequate circulation and significantly improve end-organ function. Of the 77 protocol-defined serious adverse events, most occurred within 30 days of implantation. No patients died as a direct result of pump failure or malfunction. After implantation, patient functional status improved, with 70% of patients achieving hospital discharge, and resource use was reduced. Conclusions: This trial demonstrated a favorable efficacy and safety profile for use of the VentrAssist LVAD in BTT patients.
引用
收藏
页码:579 / 588
页数:10
相关论文
共 21 条
  • [1] Bridge to transplantation with the MicroMed DeBakey ventricular assist device axial pump: a single centre report
    Bruschi, Giuseppe
    Ribera, Elena
    Lanfranconi, Marco
    Russo, Claudio
    Colombo, Tiziano
    Garatti, Andrea
    Oliva, Fabrizio
    Milazzo, Filippo
    Frigerio, Maria
    Vitali, Ettore
    [J]. JOURNAL OF CARDIOVASCULAR MEDICINE, 2006, 7 (02) : 114 - 118
  • [2] Clegg AJ, 2005, HEALTH TECHNOL ASSES, V9, P1
  • [3] Mechanical circulatory support device database of the International Society for Heart and Lung Transplantation: Third Annual Report - 2005
    Deng, MC
    Edwards, LB
    Hertz, MI
    Rowe, AW
    Keck, BM
    Kormos, R
    Naftel, DC
    Kirklin, JK
    Taylor, DO
    [J]. JOURNAL OF HEART AND LUNG TRANSPLANTATION, 2005, 24 (09) : 1182 - 1187
  • [4] Esmore Donald, 2005, Heart Lung Circ, V14, P163, DOI 10.1016/j.hlc.2005.03.019
  • [5] VentrAssist™ left ventricular assist device:: Clinical trial results and Clinical Development Plan update
    Esmore, Donald
    Spratt, Phillip
    Larbalestier, Robert
    Tsui, Steven
    Fiane, Arnt
    Ruygrok, Peter
    Meyers, Deborah
    Woodard, John
    [J]. EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2007, 32 (05) : 735 - 744
  • [6] First clinical implant of the VentrAssist left ventricular assist system as destination therapy for end-stage heart failure
    Esmore, DS
    Kaye, D
    Salamonsen, R
    Buckland, M
    Rowland, M
    Negri, J
    Rowley, Y
    Woodard, J
    Begg, JR
    Ayre, P
    Rosenfeldt, FL
    [J]. JOURNAL OF HEART AND LUNG TRANSPLANTATION, 2005, 24 (08) : 1150 - 1154
  • [7] Worldwide experience with the MicroMed DeBakey ventricular assist device® as a bridge to transplantation
    Goldstein, DJ
    [J]. CIRCULATION, 2003, 108 (10) : 272 - 277
  • [8] GUDEX C, 1988, 38 U YORK CTR HLTH E, P1
  • [9] Mechanical circulatory support therapy as a bridge to transplant or recovery (new advances)
    Kirklin, JK
    Holman, WL
    [J]. CURRENT OPINION IN CARDIOLOGY, 2006, 21 (02) : 120 - 126
  • [10] A cardiovascular extension of the Health Measurement Questionnaire
    Martin, AJ
    Glasziou, PP
    Simes, RJ
    [J]. JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, 1999, 53 (09) : 548 - 557