Clinical Evolution of Patients Using Ventricular Assist Devices as a Bridge for Transplantation

• Published in: Transplantation proceedings Vol. 50; no. 3; pp. 796 - 803
• Main Authors: Cestari, V., Pessoa, V.L., de Souza Neto, J.D., Moreira, T., Florêncio, R., de Vasconcelos, G.G., Souza, L., Braga, A., Sobral, M.G.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2018
• Subjects: Adult; Aged; Brazil; Female; Heart Failure - mortality; Heart Failure - physiopathology; Heart Failure - surgery; Heart Transplantation; Heart-Assist Devices - adverse effects; Humans; Male; Middle Aged; Odds Ratio; Retrospective Studies; Treatment Outcome; Waiting Lists - mortality
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2018.02.014

To evaluate the clinical evolution of patients with implantation of ventricular assist device (VAD) and identify the intervening factors for death. This analytical, retrospective study was carried out in a public reference hospital in cardiopulmonary diseases located in northeastern Brazil. The study population encompassed the medical records of 16 patients who underwent VAD implantation. Data collection took place from January to August 2016, through the consultation of medical records. Descriptive analysis, odds ratio, and the Fisher's Exact, Wilcoxon, Friedman and t-tests were used to analyze the data. All patients experienced complications during the use of the device, with bleeding being the main cause (11 [68.8%]). There was a significant decrease in noradrenaline (P = .025), milrinone (Primacor; P = .007), and dobutamine (P = .046) flow rates with the clinical evolution of patients. Regarding hematologic parameters, the use of VAD promoted a significant improvement in hemoglobin (P < .001), hematocrit (P = .003), activated partial thromboplastin time (P = .013), and fibrinogen (P = .049) values at the 3 time points analyzed. Regarding the clinical outcome of the patients, the majority (10 [62.5%]) underwent cardiac transplantation. This study allowed for better knowledge of the clinical evolution of patients with VAD implantation, highlighting the benefits of this type of device as a bridge for heart transplantation.