LATE BREAKING I

F. Özalp¹, T. Butt², N. Wrightson¹, T. Pillay¹, D. O'leary¹, G. Macgowan¹, S. Schueler^1
1Cardiopulmonary Transplantation, NUTH, Freeman Hospital, Newcastle upon Tyne/UNITED KINGDOM, ²Cardiopulmonary Transplantation, NUTH, Newcastle upon Tyne/UNITED KINGDOM

Body: INTRODUCTION: A new long-term device has been introduced recently for bridge to transplantation in end stage heart failure patients. METHODS: Our experience is based on 22 patients from July 2009 toJune 2010 with an average time on support of 120 days ranging from 1 to 311 days and a total of 2645 days. The underlying cadriomyopathy was dilated in 12, ischaemic in 6, familial in 2, restrictivein one and hypertrophic in one patient. Age ranged from 13 to 66 yrs. Postoperative anticoagulation consisted of Heparin switched to long term Warfarin and anti platelet agents monitored by TEGmapping. We have a very low threshold for hospital readmission. RESULTS: Implant procedures were technically feasible and the device could be accommodated entirely within the pericardium even inchildren. No mechanical RV support was necessary. Survival was 77% (17/22), 3 patients died early two with MOF and one with perioperative brain stem infarct. One patient died after 6 months due tochronic RV failure and one patient after 6 months due to thromboembolic stroke. One patient was successfully transplanted. Hospital readmission occurred in 8(36%) patients. There was one incident ofupper GI-Bleed (4,5%) 2 weeks post-op requiring blood transfusion. Driveline infections occurred in 3 (14%) patients requiring antimicrobial/surgical intervention. CONCLUSIONS: This new LVAD is asafe and reliable longer-term implantable device. Implantation is significantly less traumatic than in some other devices. Hospital readmission rate is equivalent to the one after hearttransplantation. In our VAD program the HeartWare system is the device of choice for bridge to transplantation. Broader application as destination and extension of life therapy should be considered.

Disclosure: All authors have declared no conflicts of interest.