BACKGROUND: In view of the major technical advances in ventricular assist devices (VAD) in recent years, the authors discuss the question whether these "artificial hearts" are still no more than a temporary measure for patients awaiting heart transplantation (HTx), or whether they can already be used as an independent form of long-term treatment. METHODS: Statistics from Eurotransplant regarding heart transplantations and transplant waiting lists in Germany are presented. Technical developments in cardiac support systems, the variation in results depending on the indication, and the findings with respect to quality of life are all discussed on the basis of a selective review of the literature and the authors' own clinical experience. RESULTS: The waiting list for heart transplantation in Germany has grown to a record size of nearly 800 patients, while fewer than 400 hearts are transplanted each year. Technical advances have improved outcomes in VAD therapy, but the outcome depends on the patient's preoperative condition. The physical performance of patients who have received VAD is comparable to that of HTx patients; nonetheless, HTx patients have a better quality of life. CONCLUSIONS: Chronic VAD therapy has become a clinical reality. Because of the greater number of patients awaiting HTx, many will not receive their transplants in time. When the decision to treat with VAD is made early, it can be used as an alternative form of treatment with a comparable one-year survival (>75%).
BACKGROUND: In view of the major technical advances in ventricular assist devices (VAD) in recent years, the authors discuss the question whether these "artificial hearts" are still no more than a temporary measure for patients awaiting heart transplantation (HTx), or whether they can already be used as an independent form of long-term treatment. METHODS: Statistics from Eurotransplant regarding heart transplantations and transplant waiting lists in Germany are presented. Technical developments in cardiac support systems, the variation in results depending on the indication, and the findings with respect to quality of life are all discussed on the basis of a selective review of the literature and the authors' own clinical experience. RESULTS: The waiting list for heart transplantation in Germany has grown to a record size of nearly 800 patients, while fewer than 400 hearts are transplanted each year. Technical advances have improved outcomes in VAD therapy, but the outcome depends on the patient's preoperative condition. The physical performance of patients who have received VAD is comparable to that of HTx patients; nonetheless, HTx patients have a better quality of life. CONCLUSIONS: Chronic VAD therapy has become a clinical reality. Because of the greater number of patients awaiting HTx, many will not receive their transplants in time. When the decision to treat with VAD is made early, it can be used as an alternative form of treatment with a comparable one-year survival (>75%).
Authors: T Akimoto; K Yamazaki; P Litwak; K N Litwak; O Tagusari; T Mori; J F Antaki; M V Kameneva; M J Watach; M Umezu; J Tomioka; R L Kormos; H Koyanagi; B P Griffith Journal: Artif Organs Date: 1999-08 Impact factor: 3.094
Authors: R V Pruijsten; N de Jonge; J H Kirkels; C Klöpping; P A F M Doevendans; A Oosterom; H Kemperman; J R Lahpor Journal: Neth Heart J Date: 2008-02 Impact factor: 2.380
Authors: D G Pennington; K R Kanter; L R McBride; G C Kaiser; H B Barner; L W Miller; K S Naunheim; A C Fiore; V Willman Journal: J Thorac Cardiovasc Surg Date: 1988-12 Impact factor: 5.209
Authors: Leslie W Miller; Francis D Pagani; Stuart D Russell; Ranjit John; Andrew J Boyle; Keith D Aaronson; John V Conte; Yoshifumi Naka; Donna Mancini; Reynolds M Delgado; Thomas E MacGillivray; David J Farrar; O H Frazier Journal: N Engl J Med Date: 2007-08-30 Impact factor: 91.245
Authors: Satoru Osaki; Niloo M Edwards; Mauricio Velez; Maryl R Johnson; Margaret A Murray; Jennifer A Hoffmann; Takushi Kohmoto Journal: Eur J Cardiothorac Surg Date: 2008-06-02 Impact factor: 4.191
Authors: Walter E Pae; John M Connell; Amos Adelowo; John P Boehmer; Reiner Korfer; Aly El-Banayosy; Roland Hetzer; Mario Vigano; Alain Pavie Journal: J Heart Lung Transplant Date: 2007-03 Impact factor: 10.247