Long-Term Continuous-Flow Left Ventricular Assist Device Support After Left Ventricular Outflow Tract Closure

Chitaru Kurihara, William E. Cohn, Masashi Kawabori, Tadahisa Sugiura, Andrew B. Civitello, Jeffrey A. Morgan

Research output: Contribution to journalArticle

Abstract

Aortic valve insufficiency can be addressed during continuous-flow left ventricular assist device (CF-LVAD) implantation by performing aortic valve repair or replacement, or patch closure of the left ventricular outflow tract (LVOT). However, few studies have examined the safety of long-term CF-LVAD support after LVOT closure. From November 2003 through March 2016, 16 patients with advanced chronic heart failure underwent CF-LVAD implantation and concomitant LVOT closure for severe aortic insufficiency. We compared their long-term outcomes with those of 510 CF-LVAD recipients without concomitant LVOT closure. Total support time was 26.1 patient-years in the LVOT-closure group and 938.6 patient-years in the CF-LVAD-only group. Survival at 30 days, 6 months, 1 year, and 2 years was similar for CF-LVAD-only patients (90.4%, 80.6%, 74.3%, 67.5%) and LVOT-closure patients (81.3%, 81.3%, 75.0%, 68.8%; p = 0.59). There were no deaths related to LVOT closure. The event rate per patient-year for neurologic dysfunction (ND) was 0.23 in the LVOT-closure group (6 ND events) and 0.20 in the CF-LVAD-only group (136 ND events; p = 0.97). We conclude that for select patients with aortic insufficiency who are undergoing CF-LVAD implantation, LVOT closure produces acceptable outcomes and, therefore, is a viable option.

Original languageEnglish (US)
Pages (from-to)558-564
Number of pages7
JournalASAIO journal (American Society for Artificial Internal Organs : 1992)
Volume65
Issue number6
DOIs
StatePublished - Aug 1 2019
Externally publishedYes

Fingerprint

Left ventricular assist devices
Heart-Assist Devices
Neurologic Manifestations
Aortic Valve Insufficiency
Aortic Valve
Repair
Heart Failure
Safety
Survival

ASJC Scopus subject areas

  • Biophysics
  • Bioengineering
  • Biomaterials
  • Biomedical Engineering

Cite this

Long-Term Continuous-Flow Left Ventricular Assist Device Support After Left Ventricular Outflow Tract Closure. / Kurihara, Chitaru; Cohn, William E.; Kawabori, Masashi; Sugiura, Tadahisa; Civitello, Andrew B.; Morgan, Jeffrey A.

In: ASAIO journal (American Society for Artificial Internal Organs : 1992), Vol. 65, No. 6, 01.08.2019, p. 558-564.

Research output: Contribution to journalArticle

Kurihara, Chitaru ; Cohn, William E. ; Kawabori, Masashi ; Sugiura, Tadahisa ; Civitello, Andrew B. ; Morgan, Jeffrey A. / Long-Term Continuous-Flow Left Ventricular Assist Device Support After Left Ventricular Outflow Tract Closure. In: ASAIO journal (American Society for Artificial Internal Organs : 1992). 2019 ; Vol. 65, No. 6. pp. 558-564.
@article{6ff22cd75bc1472fb32e7ada9baff011,
title = "Long-Term Continuous-Flow Left Ventricular Assist Device Support After Left Ventricular Outflow Tract Closure",
abstract = "Aortic valve insufficiency can be addressed during continuous-flow left ventricular assist device (CF-LVAD) implantation by performing aortic valve repair or replacement, or patch closure of the left ventricular outflow tract (LVOT). However, few studies have examined the safety of long-term CF-LVAD support after LVOT closure. From November 2003 through March 2016, 16 patients with advanced chronic heart failure underwent CF-LVAD implantation and concomitant LVOT closure for severe aortic insufficiency. We compared their long-term outcomes with those of 510 CF-LVAD recipients without concomitant LVOT closure. Total support time was 26.1 patient-years in the LVOT-closure group and 938.6 patient-years in the CF-LVAD-only group. Survival at 30 days, 6 months, 1 year, and 2 years was similar for CF-LVAD-only patients (90.4{\%}, 80.6{\%}, 74.3{\%}, 67.5{\%}) and LVOT-closure patients (81.3{\%}, 81.3{\%}, 75.0{\%}, 68.8{\%}; p = 0.59). There were no deaths related to LVOT closure. The event rate per patient-year for neurologic dysfunction (ND) was 0.23 in the LVOT-closure group (6 ND events) and 0.20 in the CF-LVAD-only group (136 ND events; p = 0.97). We conclude that for select patients with aortic insufficiency who are undergoing CF-LVAD implantation, LVOT closure produces acceptable outcomes and, therefore, is a viable option.",
author = "Chitaru Kurihara and Cohn, {William E.} and Masashi Kawabori and Tadahisa Sugiura and Civitello, {Andrew B.} and Morgan, {Jeffrey A.}",
year = "2019",
month = "8",
day = "1",
doi = "10.1097/MAT.0000000000000856",
language = "English (US)",
volume = "65",
pages = "558--564",
journal = "ASAIO journal (American Society for Artificial Internal Organs : 1992)",
issn = "1058-2916",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Long-Term Continuous-Flow Left Ventricular Assist Device Support After Left Ventricular Outflow Tract Closure

AU - Kurihara, Chitaru

AU - Cohn, William E.

AU - Kawabori, Masashi

AU - Sugiura, Tadahisa

AU - Civitello, Andrew B.

AU - Morgan, Jeffrey A.

PY - 2019/8/1

Y1 - 2019/8/1

N2 - Aortic valve insufficiency can be addressed during continuous-flow left ventricular assist device (CF-LVAD) implantation by performing aortic valve repair or replacement, or patch closure of the left ventricular outflow tract (LVOT). However, few studies have examined the safety of long-term CF-LVAD support after LVOT closure. From November 2003 through March 2016, 16 patients with advanced chronic heart failure underwent CF-LVAD implantation and concomitant LVOT closure for severe aortic insufficiency. We compared their long-term outcomes with those of 510 CF-LVAD recipients without concomitant LVOT closure. Total support time was 26.1 patient-years in the LVOT-closure group and 938.6 patient-years in the CF-LVAD-only group. Survival at 30 days, 6 months, 1 year, and 2 years was similar for CF-LVAD-only patients (90.4%, 80.6%, 74.3%, 67.5%) and LVOT-closure patients (81.3%, 81.3%, 75.0%, 68.8%; p = 0.59). There were no deaths related to LVOT closure. The event rate per patient-year for neurologic dysfunction (ND) was 0.23 in the LVOT-closure group (6 ND events) and 0.20 in the CF-LVAD-only group (136 ND events; p = 0.97). We conclude that for select patients with aortic insufficiency who are undergoing CF-LVAD implantation, LVOT closure produces acceptable outcomes and, therefore, is a viable option.

AB - Aortic valve insufficiency can be addressed during continuous-flow left ventricular assist device (CF-LVAD) implantation by performing aortic valve repair or replacement, or patch closure of the left ventricular outflow tract (LVOT). However, few studies have examined the safety of long-term CF-LVAD support after LVOT closure. From November 2003 through March 2016, 16 patients with advanced chronic heart failure underwent CF-LVAD implantation and concomitant LVOT closure for severe aortic insufficiency. We compared their long-term outcomes with those of 510 CF-LVAD recipients without concomitant LVOT closure. Total support time was 26.1 patient-years in the LVOT-closure group and 938.6 patient-years in the CF-LVAD-only group. Survival at 30 days, 6 months, 1 year, and 2 years was similar for CF-LVAD-only patients (90.4%, 80.6%, 74.3%, 67.5%) and LVOT-closure patients (81.3%, 81.3%, 75.0%, 68.8%; p = 0.59). There were no deaths related to LVOT closure. The event rate per patient-year for neurologic dysfunction (ND) was 0.23 in the LVOT-closure group (6 ND events) and 0.20 in the CF-LVAD-only group (136 ND events; p = 0.97). We conclude that for select patients with aortic insufficiency who are undergoing CF-LVAD implantation, LVOT closure produces acceptable outcomes and, therefore, is a viable option.

UR - http://www.scopus.com/inward/record.url?scp=85070797439&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85070797439&partnerID=8YFLogxK

U2 - 10.1097/MAT.0000000000000856

DO - 10.1097/MAT.0000000000000856

M3 - Article

C2 - 30074962

AN - SCOPUS:85070797439

VL - 65

SP - 558

EP - 564

JO - ASAIO journal (American Society for Artificial Internal Organs : 1992)

JF - ASAIO journal (American Society for Artificial Internal Organs : 1992)

SN - 1058-2916

IS - 6

ER -