New Circulatory Support System: Heartware M. Ozbaran, T. Yagdi, C. Engin, S. Nalbantgil, F. Ayik, E. Oguz, Y. Engin, and P. Özturk ABSTRACT Introduction. Through the new developments in medicine, heart failure therapy has advanced to mechanical circulatory support systems. The HeartWare Ventricular Assist System HVAD; HeartWare, Inc.; Miramar, Fla, USA) is a new device that is a centrifugal, intracorporeal, miniaturized and continuous flow pump that serves simple patient use and enhanced life quality. This article reports the midterm results of patients who underwent the heartware support system. Materials and methods. We retrospectively compiled our data from December 2010, including 10 patients of mean age 51.8 years with 90% males, 70% of the overall patient cohort had dilated cardiomyopathy and remaining ones, ischemic disease. Mean left ventricular ejection fraction was 20.1% and mean systolic pulmonary artery pressure was 49.2 mm Hg. A single patient was grade 1; seven were grade 2; and remaining ones, grade 3 according to the INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) scale. All patients were operated with cardiopulmonary bypass (CPB) with moderate hypothermia. Tricuspid ring annuloplasty was performed in 3 (30%) patients. In one patient we removed a left ventricular thrombus. In a case with severe aortic regurgitation, we placed a simple coaptation stitch at the central portion of the three aortic cusps under the aortic cross clamp. The mean CPB duration was 95.5 minutes. Results. There was no operative or in-hospital mortality. Mean support time was 250.67 days. During the early postoperative period, one patient experienced a minor hemorrhagic neurological event also requiring a tracheostomy due to pneumonia. This patient has completely healed and on follow-up continues a normal life. All patients were asymptomatic regarding heart failure. One patient unfortunately died because of possible pancreatic cancer and sepsis. Two patients underwent transplantations on days 159 and 172 of support. Conclusion. The HVAD system provided effective circulatory support for patients with end-stage heart failure with low adverse event rates. Long-term results are needed particularly for destination therapy candidates. T HE POOR NATURAL HISTORY of heart failure and growing waiting lists for transplantation have pro- duced an urgent need for mechanical assistance. With the technological advances of ventricular assist devices, new generation pumps now represent viable alternatives to heart transplantation with almost equal life quality at least in the early period. 1,2 Herein we have presented our early experience with the HeartWare Ventricular Assist System (HeartWare, Inc, Miramar, Fla, USA), which is a new third-generation pump. PATIENTS AND METHODS We retrospectively analyzed 10 patients with end-stage heart failure who underwent. HeartWare implantation in our center between December 2010 and August 2011. Their mean age was 51.8  11.05 years range 29 – 66 with 90% males. Seventy percent of patients displayed dilated cardiomyopathy; the remaining ones, ischemic cardiomyopathy. The main reason for mechanical circu- latory support was as a bridge to transplantation (n = 8, 80%) except 2 (20%) for whom it was destination therapy. One patient had undergone previous cardiac surgery via a sternotomy. Mean From the Departments of Cardiovascular Surgery (M.O., T.Y., C.E., F.A., E.O., Y.E., P.Ö), and Cardiology (S.N.), Ege University Hospital, Izmir, Turkey. Address reprint requests to Cagatay Engin, MD, Ege Univer- sity Hospital, Department of Cardiovascular Surgery, 35100, Bornova, Izmir, Turkey. E-mail: cagatayengin@yahoo.com 0041-1345/12/$–see front matter © 2012 Published by Elsevier Inc. http://dx.doi.org/10.1016/j.transproceed.2012.05.043 360 Park Avenue South, New York, NY 10010-1710 1726 Transplantation Proceedings, 44, 1726 –1728 (2012)