First implants of the MicroMed DeBakey VAD in Turkey

Summary form only given. Despite optimal medical therapy, patients with end-stage heart failure may deteriorate while waiting for cardiac transplantation. Bridging to transplantation with a ventricular assist device (VAD) may be a life saving procedure for these patients. We report our two cases who were implanted with MicroMed DeBakey VAD. Two male patients, 37 and 41 years old underwent implantation of a MicroMed DeBakey VAD as a bridge to heart transplantation. Both of them had end-stage left heart failure due to idiopathic cardiomyopathy and were listed for cardiac transplantation. Despite optimal medical therapy they developed acute hemodynamic deterioration. Both patients need inotropic support after implantation for adequate right heart function. The doses of the inotropes tapered in a few days and then stopped. In the early phase after implantation, pump speed was not increased above 9,000 rpm to avoid excessive suction; but after that it was set between 9,000 and 11,000 rpm to achieve mixed venous oxygen saturation of 70% with mean arterial blood pressure more than 65 mmHg. For anticoagulation we started with intravenous heparin and then switched to warfarin sodium, clopidogrel bisulfate and acetyl salysilic acid orally. Both patients are still on the device after 46 and 25 days of uncomplicated pump support. In conclusion, these are first implants of the MicroMed DeBakey VAD in Turkey. From these cases we have learned that this device is appropriate for bridge to transplant purposes.