Additional Surgical Treatment Options

Ventricular assist devices can be either univentricular (LVAD) or biventricular (RVAD or LVAD) for hemodynamic support. These devices have been used primarily as a bridge to transplant or a bridge to recovery in patients who have acute decompensated heart failure. More recently the HeartMate Left Ventricular Assist Device has been utilized as a permanent device in destination therapy. This has been utilized in patients who are not considered candidates for heart transplantation but have progressive congestive heart failure refractory to maximal medical therapy.

Indications for Ventricular Assist Device Support

• Failed medical therapy
• Refractory arrhythmias
• Failure to wean from cardiac bypass
• Reversible end-organ dysfunction due to heart failure
• Reversible acute congestive heart failure

Considerations in Univentricular Versus Biventricular Support

• Right ventricular function
• Refractory arrhythmias
• End-organ function
• Amount of pre-implant support required

Emory Experience

Novacor Left Ventricular Assist System (LVAS)

(1988-1998)

• 1 bridged to recovery and explant
• 3 expired while on support
• 10 bridged to heart transplant

Thoratec Ventricular Assist Device (VAD) System

(1999-2004)

• 1 bridged to recovery and explant
• 10 bridged to heart transplant
• 3 expired while on support (MSOF)
• 1 currently on device

Transplant Center