Schmack, Bastian, Grossekettler, Leonie, Zeriouh, Mohamed, Weymann, Alexander, Mohite, Prashant, Koch, Achim, Ruhparwar, Arjang, Simon, Andre Ruediger, Sabashnikov, Anton and Popov, Aron Frederik (2019). It keeps on turning: Effects of prolonged long-term left ventricular assist device support as a bridge to heart transplantation. Int. J. Artif. Organs, 42 (2). S. 65 - 72. LONDON: SAGE PUBLICATIONS LTD. ISSN 1724-6040
Full text not available from this repository.Abstract
Objectives: Increasing incidence of end-stage heart failure has moved the therapy with left ventricular assist devices to the forefront of surgical treatment. Moreover, continuous sophistication in this technology has resulted in increasing proportion of patients on prolonged support. Early and late complications after left ventricular assist device as a bridge to transplantation and present factors associated with long-term support and long-term outcomes of patients supported for at least 1 year were compared. Methods: A total of 163 consecutive patients who underwent left ventricular assist device implantation as bridge to transplantation were included. A total of 79 patients were supported for at least 1 year (long-term support), whereas 84 patients were supported for less than 1 year (short-term group). Results: Factors associated with a successful long-term support were male gender (p < 0.001), cessation of smoking at least 6 months prior to surgery (p = 0.045), previous implantation of implantable cardioverter defibrillator (p = 0.001) and rapid postoperative extubation (p = 0.018). Regarding echocardiographic parameters, higher left ventricular mass (p = 0.013) and larger left ventricular-end systolic (p = 0.008) and diastolic (p = 0.005) diameters prior to left ventricular assist device implantation were associated with long-term support. Short-term group showed higher mortality and higher proportion of patients who underwent device exchange due to device failure, and left ventricular assist device explantation for myocardial recovery was less frequent in the long-term support (p < 0.001). In addition, patients from the long-term support had significantly higher incidence of higher-grade aortic regurgitation (p = 0.005). Conclusion: Prolonged left ventricular assist device support as bridge to transplantation is associated with lower mortality and lower incidence of device failure requiring device exchange. However, long-term support reduces the chance of device explantation for myocardial recovery and increases the incidence of higher-grade aortic regurgitation in the follow-up.
Item Type: | Journal Article | ||||||||||||||||||||||||||||||||||||||||||||
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URN: | urn:nbn:de:hbz:38-158433 | ||||||||||||||||||||||||||||||||||||||||||||
DOI: | 10.1177/0391398818815471 | ||||||||||||||||||||||||||||||||||||||||||||
Journal or Publication Title: | Int. J. Artif. Organs | ||||||||||||||||||||||||||||||||||||||||||||
Volume: | 42 | ||||||||||||||||||||||||||||||||||||||||||||
Number: | 2 | ||||||||||||||||||||||||||||||||||||||||||||
Page Range: | S. 65 - 72 | ||||||||||||||||||||||||||||||||||||||||||||
Date: | 2019 | ||||||||||||||||||||||||||||||||||||||||||||
Publisher: | SAGE PUBLICATIONS LTD | ||||||||||||||||||||||||||||||||||||||||||||
Place of Publication: | LONDON | ||||||||||||||||||||||||||||||||||||||||||||
ISSN: | 1724-6040 | ||||||||||||||||||||||||||||||||||||||||||||
Language: | English | ||||||||||||||||||||||||||||||||||||||||||||
Faculty: | Unspecified | ||||||||||||||||||||||||||||||||||||||||||||
Divisions: | Unspecified | ||||||||||||||||||||||||||||||||||||||||||||
Subjects: | no entry | ||||||||||||||||||||||||||||||||||||||||||||
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Refereed: | Yes | ||||||||||||||||||||||||||||||||||||||||||||
URI: | http://kups.ub.uni-koeln.de/id/eprint/15843 |
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