Ventricular Assist Devices as a Bridge to Cardiac Transplantation: The Ottawa Experience

:  This article reports our experience with ventricular assist devices (VADs) as a bridge to cardiac transplan-tation.  From  1991  to  2003,  a  total  of  42  patients  received a  Thoratec  VAD  (Thoratec  Laboratories  Corporation Inc., Pleasanton, CA, U.S.A.) (Group T) and 12 patients received a Novacor VAD (WorldHeart Corporation, Ottawa, Canada) (Group N). Thirty Thoratec patients were transplanted compared to six in the Novacor group. Four more Novacor patients are still supported. Of the transplanted patients, 87% survived to hospital discharge in Group T and 67% in Group N. Infections affected 29% and 50% of Group T patients during support and post-transplantation, respectively, compared to 25% and 0%, respectively, in Group N. Neurologic complications affected 33% of patients in each group during support. Reopening rates for bleeding during support were 45% and 42% in Groups T and N, respectively. There were no significant differences in outcomes between the two groups. Our study demonstrated the effectiveness of VADs  in  bridging  mortally  ill  cardiac  patients  to  successful heart transplantation.