Clinical Use of Ventricular Assist Systems for the Terminal Stage of Dilative Card iomyopathy: Clinical Effects and Limitations

Abstract

We implanted Left ventricular assist systems on 4 patients with terminal stage of dilative cardiomyopathy (DCM) in the past 4 years. The patients were all male with average age of 47 year-old. The average of the left ventricular ejection fraction was 12.5% and that of cardiothoracic ratio was 69.3% before LVAS implantation. NCVC-LVAS was implanted on 3 patients and TCI -LVAS was implanted on one patient. One patient who required cardiac resuscitation prior to VAS implantation could not recover his consciousness and died on 14 postoperative days (POD). 3 patients were separated from respirator within 2 days and recovery of renal function was obtained within 2 weeks and that of hepatic function within 4weeks after LVAS implantation. Recovery of LV function was not obtained in 2 patients who were supported with NCVC-LVAS and died on 43 POD and 44 POD. A remarkable recovery of LV functional was obtained in the patient with TCI-LVAS, however, an accidental sudden bleeding occurred on 26 POD and died on 40 POD. Although LVAS support was very effective for the terminal stage of DCM, it is required to increase our clinical experience to maintain good circulatory and general conditions avoiding complications for more successful results.