Heartmate Left Ventricular Assist Device for Long-Term Circulatory Support

We describe three successful cases of HeartMate(R)left ventricular assist device (LVAD; Thermo Cardiosystems, Woburn, MA, USA) implantation in patients with end-stage heart failure for long-term circulatory support. Patient 1 was a 34-year-old woman with postpartum cardiomyopathy. Patients 2 and 3 were both males with dilated cardiomyopathy , 50 years and 21 years of age, respectively. The! all presented in cardiogenic shock with decreased sensorium and anuria. Temporary mechanical support with an intra -aortic balloon pump or extracorporeal membrane oxygenation (ECMO) was needed for life support. Because bleeding and right ventricular failure often occur after HeartMate(R) LVAD implantation, we used a Vascutek tube (Vascutek Ltd, Inchinnan, Scotland) graft to wrap inflow and outflow valve conduits and ECMO as a bridge to HeartMate LVAD implantation . Following surgery, cardiac output increased from 2.70, 2. 06 and 2.53 L/min to 4.50, 5.80 and 5.00 L/min in the three patients. HeartMate(R) LVAD can provide safe and stable long -term circulatory support without the need for anticoagulation, One of the patients remained on HeartMate(R ) for 287 days before undergoing successful heart transplantation. Patients with HeartMate(R) LVAD are ambulatory and may be discharged while awaiting heart transplantation. Heart function may recover after long-term ventricular unloading with HeartMate(R) LVAD