In the unstable patient with impending organ failure, implantation a temporary ventricular
assist device (VAD) is associated with a high morbidity and mortality. The use of
temporary VADs in acute cardiogenic shock produces a low survival rate. We retrospectively
reviewed 46 patients underwent temporary VAD since 2002 at Tohoku University Hospital.
Mean age was 39.4. 29 were male (61%). The etiology of heart disease included 41 (87%)
patients with primary and secondary cardiomyopathies and 6 (13%) with fulminant myocarditis.
6 patients underwent heart transplantation, 4 weaned from temporary VAD following
cardiac recovery, and 10 underwent conversion to durable VAD. In the overall cohort,
there were 26 deaths. The patients who died after device implantation were older (P = .002) and supported with BVAD (P = .001). The causes of death were stroke (11), MOF (10), bleeding (3), ARDS (1),
and mediastinitis (1). The survival rates were 89%, 72%, 51%, and 47% at 1 month,
3 month, 6 month and 1 year after device implantation. The optimal use of temporary
VAD has not been completely elucidated. Alternative strategy is necessary for patients
with cardiogenic shock especially biventricular failure.
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