Bridging cardiogenic shock patients with short-term ventricular support at a community hospital to long-term ventricular support at a tertiary hospital

José González-Costello, Jonathan Yang, Daniel B. Sims, Alexander P. Kossar, Lindsay K. Murray, Paolo C. Colombo, Hiroo Takayama, Donna Mancini, Yoshifumi Naka, Ulrich P. Jorde, Nir Uriel

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Background: Patients in cardiogenic shock require immediate circulatory support. Outcomes of patients who underwent short-term ventricular assist device (STVAD) implantation in a community hospital (CH) as a bridge to a long-term VAD (LTVAD) were compared with those who received both implants at the same tertiary hospital (TH). Methods: Data were retrospectively reviewed for patients with a STVAD who were bridged to a LTVAD in a TH from 1997 to 2010. We studied outcomes and survival censored for cardiac transplantation. Results: Thirty-seven patients (73% male) were identified. Mean age was 52 ± 16 years, 30% were diabetic, and 65% had intra-aortic balloon pump support. Reasons for STVAD implantation were an acute myocardial infarction, 38%; post-cardiotomy, 38%, decompensated chronic heart failure, 19%; and others, 5%. A STVAD was implanted in a CH in 20 patients (54%), and they had fewer cardiovascular risk factors than those whose STVAD was implanted at the TH. All patients at the CH were at Interagency Registry for Mechanically Assisted Circulatory Support 1 compared with 71% at the TH (p = 0.014). Patients from the CH tended to die sooner after LTVAD implant, although long-term survival was similar. At the 1-year follow-up, 65% from the CH were alive or had received a transplant vs 60% from the TH. Conclusion: Patients with cardiogenic shock in whom a STVAD was implanted in a CH and then were bridged to a LTVAD in a TH had similar long-term survival as those bridged to LTVAD at the TH.

Original languageEnglish (US)
Pages (from-to)618-624
Number of pages7
JournalJournal of Heart and Lung Transplantation
Volume31
Issue number6
DOIs
StatePublished - Jun 2012
Externally publishedYes

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Keywords

  • cardiogenic shock
  • community hospital
  • long-term ventricular assist device
  • short-term ventricular assist device
  • tertiary hospital

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

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