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.