Ventricular Assist Devices - Heart Transplant
Pre-transplant circulatory support in Spain has traditionally been done
with short-term devices that enabled effective and sufficient support
until the arrival of the organ in a matter of days, since the donation
system by the Transplant National Organization (the “Spanish Model”)
has achieved short waiting times. The trade-off is that long-term
circulatory support has had a slow development and a reduced experience
in Spain in comparison with the surrounding countries, amounting to a
total of 40-50 implants per year for all indications in recent years.
In this scenario, the impact of the coronavirus pandemic on ventricular
assist devices has been minimal. Excluding ECMO support to COVID-19
patients, emergency implants have only been performed in situations of
cardiogenic shock and as urgent pre-transplant support, and even in
these cases, the devices used have been short-term ones
(Impella®, ECMO). Elective heart transplants were
suspended in most of the Spanish groups for two months, so non-urgent
patients, assisted with long-term devices, remained on the waiting list.
In the post-COVID era, we should not expect major changes in both device
indications and implantation strategy.