Implantable Left Ventricular Assist Device for End Stage Heart Disease-Our Institutional Experience Rajamani Selvakumar, Prakash P.V.S., Immanuel S Sam, Dr. Shetty Devi P, Dr. Punnen Julius, Dr. Shetty Varun Narayana Hrudayalaya, Bengalur Online published on 7 December, 2019. Abstract Background Patients with end-stage heart failure require support and assistance for their damaged left ventricle. Left ventricular assist devices (LVADs) provides circulatory support and are an alternative to heart transplant for these irreversibly damaged LV. They are initiated as a bridge to transplant or as destination therapy. Material and Methods We have a modest experience of 11 patients who were put on implantable LVAD. Their EF was in the range of 15–25%. Our Inclusion Criteria included patients with advanced heart failure symptoms (NYHA Class III or IV), on optimal medical management and are failing to respond or Class IV heart failure and dependent on IABP and/or inotropes, VO2max <=14 ml/kg/min. We have an experience of 4 Ventracore assist LVAD and 7 Heartmate II LVAD implantation cases. Results In our experience of 11 patients, 8 patients survived (72.7%). Out of the four Ventracore LVAD one succumbed due to septicemia in the immediate postoperative period. One patient survived for nearly six years and expired at home. One patient required Dorr's repair due to LV wall thinning after few months of implantation hence the VAD was explanted and Dorr was performed. After 10 years one patient underwent successful orthotopic transplantation and explantation of the VAD. Out of the seven Heartmate II patients 5 survived and two succumbed one due to septicemia and another due to septicemia. One patient who belonged to INTERMACS 3 underwent LVAD with park's stitch for Aortic Incompetence and was successfully discharged. One patient INTERMACS 1 required temporary RVAD and succumbed in the postoperative period due to multiorgan dysfunction. We found out that patient who belonged to INTERMACS 3–4 profile had better outcome and the recovery was fast in the postoperative period. Patients who were in the INTERMACS 1–2 had a long post operative stay with lot of co-morbidities. Conclusion LVAD support as a bridge-to-transplant or as destination therapy has been shown to improve the survival rate, improved life style of patients who were suffering from end stage heart disease. The role of perfusionist in the Implantable VADs is vital and has opened a new career to pursuit. Top Keywords Left Ventricular assist device, Right ventricular assist device, INTERMACS-Interagency Registry Mechanical Assist Circulatory Support. Top |