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Influence of Different Assist Devices on Survival after Orthotopic Heart Transplantation

Background In 1995, a risk factor of 1.88 was indicated for one-year mortality in connection with bridging to heart transplantation (1). Both one-year and three-year survival rates in patients bridged to transplantation were less than 80% (2). Methods From 3/89 to 12/98, 903 orthotopic heart transplantations were performed at our center in 888 recipients. Bridging was necessary in 142 patients. Results The one-year survival rate was 76% in pts without VAD, 86% in pts bridged with VAD and 66% in pts with VAD due to postcardiotomy syndrome. The three-year survival rates were 73%, 80% and 55% respectively. Conclusions Early and late results in patients bridged to transplantation remarkably improved over 1995 (1). One-year and long-term survival rates are significantly lower when assist devices are used in patients with postcardiotomy syndrome. Despite a high incidence of assist-related complications, electively bridged patients showed significantly better early and long-term results than the control group.