7 Early experience with implantable LVAD at samsung medical centre, seoul

Abstract

The number of heart transplantation in Korea has been growing steadily. However, the waiting time for transplantation is also increasing. For 6 years, we have been implanting left ventricular assist devices (LVAD). Up to October 2017, 15 patients have had LVAD implanted at Samsung Medical Centre (see table 1). There were 5 bridge-to-candidacy patients and 10 destination therapy (DT) patients. Age range was 47 to 81 years. Six patients (40%) were on extracorporeal membrane oxygenation (ECMO) support and 4 were on dialysis preoperatively. Three patients required post-operative temporary right VAD support. There were no early (30 day) deaths, but 2 late deaths occurred. During the study period, LVAD were not covered by any Korean insurance system. At present, the role of LVAD is limited to bridge-to-candidacy or DT. However, in the near future, it may be utilised for purely bridge-to-transplantation. Abstract 7 Table 1 Brief summary of LVAD cases performed at Samsung medical centre, Seoul, South Korea Sex/age Strategy INTERMACS profile Aetiology Reason for LVAD Pre-ECMO Current status M/75 DT 3 DCMP, s/p AVR Old age No Survival for 5.2 years M/66 DT 3 ICMP, s/p CABG COPD No Survival for 4.3 years M/73 DT 3 DCMP Old age No HTx after 1.9 years F/62 BTC 3 ICMP, s/p CABG Foreigner (unable to return to home country due to advanced HF) Yes Survival for 2.4 years F/79 DT 3 ICMP Old age, CKD No Survival for 2 years M/49 BTC 2 ICMP Infection, cachexia Yes Survival for 1.9 years F/48 BTC 2 DCMP (chemotherapy-induced) Cancer Yes Death after 13 months F/77 DT 3 ICMP Old age No Survival for 13 months M/62 BTC 2 ICMP Infection, cachexia Yes Survival for 11 months M/81 DT 1 DCMP, s/p AVR, CABG Old age No Survival for 8 months M/69 DT 2 ICMP Pneumonia, cachexia Yes Survival for 7 months M/47 BTC 2 DCMP (alcoholic) Substance abuse No Survival for 7 months M/69 DT 2 ICMP Infection, cachexia Yes Survival for 6 months M/74 DT 3 DCMP Old age, CKD No Survival for 5 months F/80 DT 2 DCMP Old age, CKD No Survival for 4 months AVR, aortic valve replacement. BTC, bridge-to-candidacy. CABG, coronary artery bypass grafting. CKD, chronic kidney disease. DCMP, dilated cardiomyopathy. DT, destination therapy. F, female. HTx, heart transplantation. ICMP, ischaemic cardiomyopathy. M, male. s/p, status post