Original Article


Left ventricular assist device (LVAD) program in Chile: first successful experience in South America

Oneglio Pedemonte, Andres Vera, Lorenzo Merello, Manuel Novajas, Fernando Aranda, Julio Ibarra, Jose A. Muñoz, Javier Alburquerque, Paulina Espinoza, Felipe Cárdenas, Ernesto Aránguiz-Santander

Abstract

Background: The need to have a variety of tools to deal with end-stage heart failure (ES-HF), along with the limited heart transplantation availability encouraged us to create a pilot Left ventricular assist device (LVAD) program in a public health care system hospital in Chile.
Methods: A retrospective analysis of the first nine patients of an ongoing LVAD program initiated on August 2013 was performed, completing an average of 30 months of follow-up. The most important events regarding to morbidity and mortality are described.
Results: Nine patients with ES-HF underwent LVAD implantation surgery; one of them died 23 days after surgery and another died after 11 months. One patient successfully underwent heart transplantation after 16 months of HeartWare ventricular assist device (HVAD) support; the other six patients remain in the program and have an average follow-up of 846 days at the time of this study (range, 23–1,481 days). The survival rate at 6, 12 and 18 months follow-up was 89%, 78% and 78% respectively.
Conclusions: This new pioneering LVAD program in Chile has been successful and now constitutes a vital adjunct to all who work in heart transplantation and ES-HF programs. It offers an effective therapeutic alternative when there is a severe donor shortage, in cases of atypical blood types, emergencies, exceptional cases with contraindication for heart transplantation or when there is important donor-receiver size mismatch.

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