916-87 Abiomed Ventricular Assist Device as a Bridge to Transplantation

The Abiomed BVS 5000 ventricular assist device (VAD) is simple to implant and monitor and allows for uni- or bi-ventricular support. Previous trials have demonstrated the efficacy of this device for short-term post-cardiotomy support. We report our experience using this VAD for circulatory support as a bridge to transplantation.Twenty-six patients underwent Abiomed placement as a bridge to transplantation between January 1988 and July 1994 in three institutions. Indications included end-stage cardiomyopathy (18), post cardiotomy failure (6), and acute rejection (2). Average age among recipients was 44 years (7–60). and average duration of support was 6 days (1–13 days). Twenty-one patients received biventricular while 5 had univentricular (4 left. 1 right) support. One patient was bridged to a long-term device prior to transplantation and a second patient with a long-term support device underwent Abiomed placement for right heart failure. Complications were seen in 9 patients and included reversible (4) and irreversible (1) neurological deficits and bleeding requiring re-exploration (4). No infectious complications were seen. Following transplantation, 16 patients (62%) were discharged from the hospital and 10 patients (38%) succumbed to multisystem organ failure.The Abiomed VAD is suitable circulatory support as a bridge to a long-term device or cardiac transplantation and is particularly useful for individuals who are too small for alternative devices or who are too unstable for long-term device placement