test 8 history of bridge to transport

Question 1

History - VAD as A BTT

Answer 1

 Transplantation provided a stimulus for the development of VADs for support until transplant.
 Early 1980s – Transplantation became a widely applied therapy.
 30% of patients died on the list
 Became an incentive to develop devices that could be used for patients with acute cardiac decompensation while awaiting transplantation.

Question 2

1980

Answer 2

– NIH sent out request for proposals
 To develop an “implantable, integrated, electrically powered left heart assist system” that could be used on a long term basis and allow extensive patient mobility.

Question 3

9/1984 – Stanford University

Answer 3

 Oyer and Colleagues – Implanted the Novacor LVAD
 1st successful transplant s/p BTT with LVAD
 Followed by Hill and colleagues who implanted a Pearce-Donachey pneumatic LVAD.

Question 4

1992

Answer 4

– Frazier and colleagues
 1st to report successful BTT with Thoratec Heartmate IP VAD
 Implantable Pneumatic
 Restored near normal hemodynamics.
 Limitations –
 Devices dependent on large consoles for power and controller function
 Patients confined to hospital until transplantation despite being fully ambulatory.

Question 5

1990

Answer 5

– Kormos at University of Pittsburg

 Developed a program to transfer VAD patients to a monitored outpatient setting until transplantation.

Question 6

1991

Answer 6

– Frazier at Texas Heart Institute
 First to use an untethered Vented Electric LVAD for long term support
 33 y/o patient
 Battery operated Heartmate VE
 500 days of support
 Patient died of embolic cerebral vascular accident.

Question 7

1990s

Answer 7

– FDA sponsored several multi-institution trials of assist devices as bridge to transplant and bridge to recovery.

Question 8

1994

Answer 8

– Heartmate LVAD was the first FDA approved implantable device for bridge to transplant.