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Journal of Artificial Organs

, Volume 21, Issue 4, pp 405–411 | Cite as

Single-center experience of the bridge-to-bridge strategy using the Nipro paracorporeal ventricular assist device

  • Shuichi Yoshitake
  • Osamu Kinoshita
  • Kan Nawata
  • Yasuhiro Hoshino
  • Yoshifumi Itoda
  • Mitsutoshi Kimura
  • Haruo Yamauchi
  • Minoru Ono
Original Article Artificial Heart (Clinical)
  • 60 Downloads

Abstract

Currently, we use the Nipro paracorporeal VAD (p-VAD) for initial short-term ventricular support, as a bridge to decision (BTD) or a bridge to candidacy (BTC) treatment, in Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) levels 1 and 2 patients. However, it is possible that compared to patients with primary implantable-VADs (P-iVAD), the bridge-to-bridge (BTB) patients are more likely to develop complications. This retrospective study used data from 24 consecutive BTB patients who were initially implanted with Nipro p-VAD as BTD or BTC treatments between April 2011 and March 2016, and subsequently underwent conversion to an i-VAD. The data from 72 patients who underwent a primary i-VAD (P-iVAD) procedure were used for comparison. Between the two groups, there was no significant difference in the incidence of infectious events (p = 0.72) or stroke (p = 0.44). Orthotropic heart transplantation was performed in 6 of the 24 patients in the BTB group and in 21 of the 72 patients in the P-iVAD group. The 1- and 2-year survival rates were 95.8% and 95.8% in the BTB group and 91% and 85.8% in the P-iVAD group; these values were not significantly different between groups (p = 0.91). Based on these results we conclude that BTB using Nipro p-VAD is a reasonable strategy for treating patients with severe decompensated end-stage heart failure.

Keywords

Bridge to bridge Heart transplantation Ventricular-assist device Heart failure 

Notes

Compliance with ethical standards

Conflict of interest

No disclosure on this study.

References

  1. 1.
    Rousse N, Juthier F, Pincon C, Hysi I, Banfi C, Robin E, et al. ECMO as a bridge to decision: recovery, VAD, or heart transplantation? Int J Cardiol. 2015;187:620–7.CrossRefGoogle Scholar
  2. 2.
    Suwa H, Seguchi O, Fujita T, Murata Y, Hieda M, Watanabe T, et al. Paracorporeal ventricular assist device as a bridge to transplant candidacy in the era of implantable continuous-flow ventricular assist device. J Artif Organs. 2014;17:16–22.CrossRefGoogle Scholar
  3. 3.
    Yoshioka D, Sakaguchi T, Saito S, Miyagawa S, Nishi H, Yoshikawa Y, et al. Initial experience of conversion of Toyobo paracorporeal left ventricular assist device to DuraHeart left ventricular assist device. Circ J. 2012;76:372–6.CrossRefGoogle Scholar
  4. 4.
    Morita S. An old ventricular assist device still working for patients with end-stage heart failure in Japan. Circ J. 2010;75:53–4.CrossRefGoogle Scholar
  5. 5.
    Saito S, Matsumiya G, Sakaguchi T, Fujita T, Kuratani T, Ichikawa H, et al. Fifteen-year experience with Toyobo paracorporeal left ventricular assist system. J Artif Organs. 2009;12:27–34.CrossRefGoogle Scholar
  6. 6.
    Takayama H, Soni L, Kalesan B, Truby LK, Ota T, Cedola S, et al. Bridge-to-decision therapy with a continuous-flow external ventricular assist device in refractory cardioogenic shock of various causes. Circ Heart Fail. 2014;7:799–806.CrossRefGoogle Scholar
  7. 7.
  8. 8.
    Brown JL, Estep JD. Temporary percutaneous mechanical circulatory support in advanced heart failure. Heart Fail Clin. 2016;12:385–98.CrossRefGoogle Scholar
  9. 9.
    Imamura T, Kinugawa K, Hatano M, Fujino T, Muraoka H, Inaba T, Maki H, Kagami Y, Endo M, Kinoshita O, Nawata K, Kyo S, Ono M. Preoperative beta-blocker treatment is a key for deciding left ventricular assist device implantation strategy as a bridge to recovery. J Artif Organs. 2014;17:23–32.CrossRefGoogle Scholar
  10. 10.
    Kashiwa K, Nishimura T, Saito A, Kubo H, Fukaya A, Tamai H, Yambe T, Kyo S, Ono M. Left heart bypass support with the Rotaflow Centrifugal Pump as a bridge to decision and recovery in an adult. J Artif Organ. 2012;15:207–10.CrossRefGoogle Scholar
  11. 11.
    Yoshitake S, Itoda Y, Nawata K, Iwase T, Hoshino Y, Kimura M,et al. Successful management of apical abscess after Nipro left ventricular assisted device explantation by removal of apical cuff and omentopexy. J Artif Organs. 2016;19:396–8.CrossRefGoogle Scholar

Copyright information

© The Japanese Society for Artificial Organs 2018

Authors and Affiliations

  • Shuichi Yoshitake
    • 1
  • Osamu Kinoshita
    • 1
  • Kan Nawata
    • 1
  • Yasuhiro Hoshino
    • 1
  • Yoshifumi Itoda
    • 1
  • Mitsutoshi Kimura
    • 1
  • Haruo Yamauchi
    • 1
  • Minoru Ono
    • 1
  1. 1.Department of Cardiac Surgery, Department of Cooperative Unit of Medicine and Engineering ResearchThe University of TokyoTokyoJapan

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