Comparison of the CardioWest total artificial heart, the novacor left ventricular assist system and the thoratec ventricular assist system in bridge to transplantation.
Comparison of the CardioWest total artificial heart, the novacor left ventricular assist system and the thoratec ventricular assist system in bridge to transplantation.
复制标题
CardioWest 全人工心脏、novacor 左心室辅助系统和 thoratec 心室辅助系统在移植过渡过程中的比较。
DOI：
10.1016/s0003-4975(00)02625-4
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发表时间：
2001
期刊：
影响因子：
--
通讯作者：
Kathleen A. Chisholm
中科院分区：
文献类型：
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作者：
Jack G. Copeland;Richard Smith;F. Arabía;Paul E. Nolan;Vinod K. Mehta;M. McCarthy;Kathleen A. Chisholm
背景设备选择历来由最少的比较数据支持。自1994年以来，我们已经植入了43例患者，其中43例植入了心脏西部全人工心脏(CW)，23例植入了Novacor左心室辅助系统(N)，26例植入了Thoratec心室辅助系统(T)。这一经验为我们的设备选择标准提供了基础。方法我们回顾了CW、N和T组的存活率、中风和感染的结果。统计方法包括学生t检验、χ2分析和Kaplan-Meier精算生存曲线。CW组平均中心静脉压(CVP)最高，平均心脏指数最低。CW组、N组和T组的移植存活率分别为75%、57%和38%。术后多器官衰竭是CW组和T组的主要死亡原因。右心衰竭和中风导致的死亡人数最多。CW组、N组和T组的线性化卒中发生率(事件/患者月)分别为0.03、0.28和0.08。CW组、N组和T组的严重感染发生率分别为20%、30%和8%，但线性化比率差异不大，感染死亡率较低。结论N装置适用于体表面积(BSA)>1.7m2、右心衰竭程度较轻的“稳定”患者。有双心衰的不稳定患者如果BSA大于1.7m2，则应接受CW，如果BSA小于1.7m2，则应接受T。
BackgroundDevice selection has historically been supported by minimal comparative data. Since 1994, we have implanted 43 patients with the CardioWest Total Artificial Heart (CW), 23 with the Novacor Left Ventricular Assist System (N), and 26 with the Thoratec Ventricular Assist System (T). This experience provides a basis for our device selection criteria.MethodsWe reviewed retrospectively the results for survival, stroke, and infection in the CW, N, and T groups. Statistical methods included the Student’s t-test, χ2analysis, and Kaplan-Meier actuarial survival curves.ResultsThe T group patients were younger and smaller sized than the CW or N group. The CW group had the highest mean central venous pressure (CVP) and lowest mean cardiac index. Survival to transplantation was 75% for CW, 57% for N, and 38% for T. Multiple organ failure postimplant caused most deaths in the CW and T groups. Right heart failure and stroke caused most N deaths. Linearized stroke rates (event/patient-month) were 0.03 for CW, 0.28 for N, and 0.08 for T. Serious infections were found in 20% of CW, 30% of N, and 8% of T patients, but linearized rates showed little difference and death from infection was rare.ConclusionsThe N device should be used in “stable” patients with body surface area (BSA) greater than 1.7 m2and with minimal right heart failure. Unstable patients with biventricular failure should receive a CW if the BSA is greater than 1.7 m2or a T if they are smaller.