Introduction: In 1998 the Heart Centre at the Danish National University Hospital implemented a new programme with long-term mechanical circulatory assist to patients with terminal heart failure who could not wait for a donor heart. A so-called Mechanical Heart, HeartMate 1, was to replace a failing left ventricle so that the patient could be resuscitated and await heart transplantation. The aim of the present study is to describe the results of this new treatment in Denmark.
Materials and methods: A total of 28 patients with a mean age of 41 years were treated with the HeartMate 1 system in the period 1998 to 2006. Two patients had the system changed to a new HeartMate 1 due to mechanical problems. Both patients were later successfully heart transplanted. A third patient had the system successfully changed to a HeartMate 2 and he is waiting for a donor heart.
Results: Hemodynamic observations reveal fast improvement after implantation of the HeartMate system. Patients who were later heart transplanted had the HeartMate system implanted for a mean of 220 days. About 90% of those that were transplanted later improved due to the system from New York Heart Associations class IV to class I-II and they could often be discharged to a normal social life with a well-functioning HeartMate. Calculated 1-year survival with the HeartMate system was 82%.
Conclusion: Patients with terminal heart failure can be treated and improved by implantation of the HeartMate system and await successful heart transplantation. Permanent advanced assist systems do exist today and these can be applied as a final treatment in selected patients--so-called destination therapy with mechanical circulatory support. The present study shows that it is very likely that the Heart Centre at the Danish National University Hospital will be able to establish a well-functioning programme for destination therapy.