Universität zu Köln

Sabashnikov, Anton ORCID: 0000-0002-6289-1035, Mohite, Prashant N., Weymann, Alexander, Patil, Nikhil P., Hedger, Mike, Saez, Diana Garcia, Zych, Bartlomiej, Wahlers, Thorsten, Wippermann, Jens, De Robertis, Fabio, Bahrami, Toufan, Amrani, Mohamed, Simon, Andre R. and Popov, Aron-Frederik ORCID: 0000-0003-4226-3004 (2014). Outcomes after implantation of 139 full-support continuous-flow left ventricular assist devices as a bridge to transplantation. Eur. J. Cardio-Thorac. Surg., 46 (5). S. E59 - 8. CARY: OXFORD UNIV PRESS INC. ISSN 1873-734X

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Abstract

Left ventricular assist devices (LVADs) are a routine treatment for patients with advanced heart failure as a bridge to transplantation. The aim of this study was to present our institutional experience and mid-term outcomes after implantation of 139 continuous-flow (cf) LVADs as a bridge to transplantation. One hundred and thirty-nine consecutive LVAD implantations were performed in our institution between July 2007 and August 2013. The mean age of the population was 44.0 +/- 13.7 years and 24 (17%) of the patients were female. A substantial number of the patients were on preoperative mechanical support: 35 (25%) with an intra-aortic balloon pump, 9 (6.5%) with an extracorporeal membrane oxygenator and 25 (18%) with previous LVAD, for LVAD exchange. The mean support duration was 514 +/- 481 days, whereas the longest support duration was 2493 days (> 6 years). The overall cumulative survival rate following cfLVAD implantation was 89% at 30 days, 76% at 1 year and 66% at 2 years (Fig. 1). There was a statistically significant difference in survival in favour of first LVAD implantation compared with VAD exchange: 91 vs 80% at 30 days, 79 vs 57% at 1 year and 70 vs 43% at 2 years (log-rank P = 0.010). Postoperatively, patients had a significant improvement in end-organ function 1 month after LVAD implantation. In addition, comparison of two different devices [HeartMate II (HM II) and HeartWare] using propensity score matching showed no significant differences in survival and most postoperative adverse events. However, patients supported with HM II required significantly more units of fresh frozen plasma (P = 0.020) with a trend towards a higher use of red blood cells (P = 0.094), and were also more likely to develop percutaneous site infections (P = 0.022). HM II and HeartWare cfLVADs have excellent early postoperative outcomes and good mid-term survival, despite a considerable number of patients needing VAD exchange.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Sabashnikov, Anton UNSPECIFIED orcid.org/0000-0002-6289-1035 UNSPECIFIED Mohite, Prashant N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Weymann, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Patil, Nikhil P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hedger, Mike UNSPECIFIED UNSPECIFIED UNSPECIFIED Saez, Diana Garcia UNSPECIFIED UNSPECIFIED UNSPECIFIED Zych, Bartlomiej UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Wippermann, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED De Robertis, Fabio UNSPECIFIED UNSPECIFIED UNSPECIFIED Bahrami, Toufan UNSPECIFIED UNSPECIFIED UNSPECIFIED Amrani, Mohamed UNSPECIFIED UNSPECIFIED UNSPECIFIED Simon, Andre R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Popov, Aron-Frederik UNSPECIFIED orcid.org/0000-0003-4226-3004 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-424187
DOI:	10.1093/ejcts/ezu325
Journal or Publication Title:	Eur. J. Cardio-Thorac. Surg.
Volume:	46
Number:	5
Page Range:	S. E59 - 8
Date:	2014
Publisher:	OXFORD UNIV PRESS INC
Place of Publication:	CARY
ISSN:	1873-734X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MECHANICAL CIRCULATORY SUPPORT; ADVANCED HEART-FAILURE; EXPERIENCE; SYSTEM Multiple languages Cardiac & Cardiovascular Systems; Respiratory System; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/42418