Short and long term outcomes of 200 patients supported by continuous-flow left ventricular assist devices

Authors

Athanasios Tsiouris
Gaetano Paone, Henry Ford HealthFollow
Hassan Nemeh, Henry Ford HealthFollow
Jamil BorgiFollow
Celeste Williams, Henry Ford HealthFollow
David Lanfear, Henry Ford HealthFollow
Jeffrey A. Morgan

Recommended Citation

Tsiouris A, Paone G, Nemeh HW, Borgi J, Williams CT, Lanfear DE, Morgan JA. Short and long term outcomes of 200 patients supported by continuous-flow left ventricular assist devices. World J Cardiol. 2015;7(11):792-800.

Document Type

Article

Publication Date

11-26-2015

Publication Title

World J Cardiol

Abstract

AIM: To study the institutional experience over 8 years with 200 continuous-flow (CF) - left ventricular assist devices (LVAD).

METHODS: We evaluated our institution's LVAD database and analyzed all patients who received a CF LVAD as a bridge to transplant (BTT) or destination therapy from March 2006 until June 2014. We identified 200 patients, of which 179 were implanted with a HeartMate II device (Thoratec Corp., Pleasanton, CA) and 21 received a Heartware HVAD (HeartWare Inc., Framingham, MA).

RESULTS: The mean age of our LVAD recipients was 59.3 years (range 17-81), 76% (152/200) were males, and 49% were implanted for the indication of BTT. The survival rate for our LVAD patients at 30 d, 6 mo, 12 mo, 2 years, 3 years, and 4 years was 94%, 86%, 78%, 71%, 62% and 45% respectively. The mean duration of LVAD support was 581 d (range 2-2595 d). Gastrointestinal bleeding (was the most common adverse event (43/200, 21%), followed by right ventricular failure (38/200, 19%), stroke (31/200, 15%), re exploration for bleeding (31/200, 15%), ventilator dependent respiratory failure (19/200, 9%) and pneumonia (15/200, 7%). Our driveline infection rate was 7%. Pump thrombosis occurred in 6% of patients. Device exchanged was needed in 6% of patients. On multivariate analysis, preoperative liver dysfunction, ventilator dependent respiratory failure, tracheostomy and right ventricular failure requiring right ventricular assist device support were significant predictors of post LVAD survival.

CONCLUSION: Short and long term survival for patients on LVAD support are excellent, although outcomes still remain inferior compared to heart transplantation. The incidence of driveline infections, pump thrombosis and pump exchange have declined significantly in recent years.

Comments

© The Author(s) 2015, Creative Commons Attribution Non Commercial License

PubMed ID

26635927

Volume

7

Issue

11

First Page

792

Last Page

800