Objective

The NHS commissioned 5 UK Transplant centres to undertake implantation of left ventricular assist devices (LVADs) as bridge to transplantation. The aim of this study was to analyse the outcomes of the implants undertaken at one of these centre.

Methods

45 patients underwent implantation of the Thoratec Heartmate II LVAD with 3 patients undergoing late pump exchange. There has been a step wise increase in implant numbers from 4 in 2011 to 24 in 2015. This increase correlates with an increase in the number of referrals for heart transplantation versus the relative static number of organs offered to our centre for transplantation. The prospectively collected data on all 48 implants was collated and the results presented.

Results

The INTERMACS distribution included 6 patients in INTERMACS 1, 13 in II, 9 in III and 16 in IV. Prior to implantation 2 patients had been supported with VA ECMO, 2 with Impella and 6 with an IABP. There were 3 in-hospital deaths (6.7%). Inhaled NO was used in 29 (65%) and a short term RVAD in 3 (6.7%) Following discharge there have been 5 late deaths, 6 patients have been transplanted and 3 have undergone pump exchange. There are 35 (78%) survivors to date, 29 with on-going support.

Conclusion

At a median follow up of 1 year our survival data in this small cohort of patients demonstrates equivalent results to that of heart transplantation both at our centre and in the published literature. This is despite the patients in INTERMACS I and those with pulmonary hypertension being too sick for transplantation. Later follow-up will determine how durable these results are.