Heterotopic Prosthetic Ventricles as a Bridge to Cardiac Transplantation

David J. Farrar, J. Donald Hill, Laman A. Gray, D. Glenn Pennington, Lawrence R. McBride, William S. Pierce, Walter Pae, Brian Glenville, Donald Ross, Timothy A. Galbraith, G. Lionel Zumbro

Research output: Contribution to journalArticle

92 Citations (Scopus)

Abstract

Heterotopic prosthetic ventricles were used to support the circulation in 29 candidates for heart transplantation who were expected to die before procurement of a donor heart. Twenty-one of these patients (average age, 36 years) underwent successful transplantation after 8 hours to 31 days of circulatory support. The other eight patients died because their condition could not be stabilized for transplantation, despite restoration of blood flow. Fourteen patients received biventricular support; 15 received only left ventricular support, with pharmacologic assistance of right heart function. Before transplantation, blood flow from the left prosthetic ventricle averaged 2.8±0.4 liters per minute per square meter of body-surface area, and from the right prosthesis 2.4±0.4 liters, as compared with an average flow of 1.6±0.5 liters per minute per square meter before implantation. Of the 21 patients who received heart transplants, 20 were discharged from the hospital after a median of 31 days. Nineteen patients were alive at 7 to 39 months, and 11 of the first 12 were alive at one year. We conclude that heterotopic placement of prosthetic ventricles as a bridge to transplantation provides an effective method of temporarily supporting cardiac function in critically ill patients without removing the natural heart. The early survival rate after transplantation is similar to that with elective cardiac transplantation. (N Engl J Med 1988; 318:333–40.)

Original languageEnglish (US)
Pages (from-to)333-340
Number of pages8
JournalNew England Journal of Medicine
Volume318
Issue number6
DOIs
StatePublished - Feb 11 1988

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Heart Transplantation
Transplantation
Body Surface Area
Critical Illness
Prostheses and Implants
Heart Ventricles
Survival Rate
Tissue Donors
Transplants

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Farrar, D. J., Hill, J. D., Gray, L. A., Pennington, D. G., McBride, L. R., Pierce, W. S., ... Zumbro, G. L. (1988). Heterotopic Prosthetic Ventricles as a Bridge to Cardiac Transplantation. New England Journal of Medicine, 318(6), 333-340. https://doi.org/10.1056/NEJM198802113180601
Farrar, David J. ; Hill, J. Donald ; Gray, Laman A. ; Pennington, D. Glenn ; McBride, Lawrence R. ; Pierce, William S. ; Pae, Walter ; Glenville, Brian ; Ross, Donald ; Galbraith, Timothy A. ; Zumbro, G. Lionel. / Heterotopic Prosthetic Ventricles as a Bridge to Cardiac Transplantation. In: New England Journal of Medicine. 1988 ; Vol. 318, No. 6. pp. 333-340.
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Farrar, DJ, Hill, JD, Gray, LA, Pennington, DG, McBride, LR, Pierce, WS, Pae, W, Glenville, B, Ross, D, Galbraith, TA & Zumbro, GL 1988, 'Heterotopic Prosthetic Ventricles as a Bridge to Cardiac Transplantation', New England Journal of Medicine, vol. 318, no. 6, pp. 333-340. https://doi.org/10.1056/NEJM198802113180601

Heterotopic Prosthetic Ventricles as a Bridge to Cardiac Transplantation. / Farrar, David J.; Hill, J. Donald; Gray, Laman A.; Pennington, D. Glenn; McBride, Lawrence R.; Pierce, William S.; Pae, Walter; Glenville, Brian; Ross, Donald; Galbraith, Timothy A.; Zumbro, G. Lionel.

In: New England Journal of Medicine, Vol. 318, No. 6, 11.02.1988, p. 333-340.

Research output: Contribution to journalArticle

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N2 - Heterotopic prosthetic ventricles were used to support the circulation in 29 candidates for heart transplantation who were expected to die before procurement of a donor heart. Twenty-one of these patients (average age, 36 years) underwent successful transplantation after 8 hours to 31 days of circulatory support. The other eight patients died because their condition could not be stabilized for transplantation, despite restoration of blood flow. Fourteen patients received biventricular support; 15 received only left ventricular support, with pharmacologic assistance of right heart function. Before transplantation, blood flow from the left prosthetic ventricle averaged 2.8±0.4 liters per minute per square meter of body-surface area, and from the right prosthesis 2.4±0.4 liters, as compared with an average flow of 1.6±0.5 liters per minute per square meter before implantation. Of the 21 patients who received heart transplants, 20 were discharged from the hospital after a median of 31 days. Nineteen patients were alive at 7 to 39 months, and 11 of the first 12 were alive at one year. We conclude that heterotopic placement of prosthetic ventricles as a bridge to transplantation provides an effective method of temporarily supporting cardiac function in critically ill patients without removing the natural heart. The early survival rate after transplantation is similar to that with elective cardiac transplantation. (N Engl J Med 1988; 318:333–40.)

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Farrar DJ, Hill JD, Gray LA, Pennington DG, McBride LR, Pierce WS et al. Heterotopic Prosthetic Ventricles as a Bridge to Cardiac Transplantation. New England Journal of Medicine. 1988 Feb 11;318(6):333-340. https://doi.org/10.1056/NEJM198802113180601