Five-year clinical experience with Abiomed BVS 5000 as a ventricular assist device for cardiac failure

Abstract

Mechanical support for the failing heart has interested and challenged cardiac specialists for decades. In the United States alone, there are close to 375 000 cardiac surgical procedures performed each year, and, despite the recent advances in myocardial protection, surgical techniques, intra-aortic balloon therapy and maximal pharmacological support, postoperative ventricular dysfunction continues to occur in 0.5-1.0% of all patients undergoing cardiac surgery. This retrospective review describes our 5-year clinical experience at the Brigham and Women's Hospital with the Abiomed BVS 5000 as a means of ventricular support. During the period of 1994 to present, 7428 cardiac surgical operations were performed at our institution. The Abiomed BVS 5000 has been implanted in 47 patients exhibiting ventricular failure. There were 38 patients in the bridge-to-recovery group and nine patients in the bridge-to-transplantation group. Twenty-five patients (66%) in the bridge-to-recovery group were weaned and 16 patients (42%) went on to discharge. In the bridge-to-transplantation group, one patient actually recovered myocardial function and one expired on the device. The remaining seven patients (77%) underwent cardiac transplantation with post-transplant survival at 66%. Overall, patients were supported in the isolated left ventricular mode (28%), in the biventricular mode (45%) and in the isolated right ventricular mode (28%). The Abiomed BVS 5000 has been shown to be a safe and simple cardiac support system with no mechanical failure. Our experience shows that a substantial number of patients suffering from ventricular failure will benefit from the use of this device. The results also justify the use of this device in groups of patients other that of postcardiotomy ventricular failure.