Long-term outcome of patients on continuous-flow left ventricular assist device support

Koji Takeda, Hiroo Takayama, Bindu Kalesan, Nir Uriel, Paolo C. Colombo, Ulrich P. Jorde, Yoshifumi Naka

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objectives: Recent advances in technology and improved patient management have enabled the use of mechanical circulatory support for unexpected long-term periods. Improved long-term outcomes may facilitate the use of device therapy as an alternative to heart transplantation. However, there are scarce data about the longterm outcomes of continuous-flow left ventricular assist devices. This study sought to evaluate the long-term outcomes in patients receiving continuous-flow left ventricular assist devices.

Methods: Between March 2004 and June 2010, 140 patients underwent continuous-flow left ventricular assist device insertion as a bridge to transplantation or a destination therapy. These patients charts were retrospectively reviewed.

Results: The initial strategy for continuous-flow left ventricular assist device therapy was bridge to transplantation in 115 patients (82%) and destination therapy in 25 patients (18%). Of those, 24 (17%) died on left ventricular assist device support, 94 (67%) were successfully bridged to transplantation, and 1 (0.71%) showed native heart recovery. Twenty-four patients (17%) had been on continuous-flow left ventricular assist device support for more than 3 years (mean, 3.9 years; range, 3.0-7.5 years). Estimated on-device survival at 1, 3, and 5 years was 83%, 75%, and 61%, respectively. Rehospitalizations due to bleeding, cardiac events, and device-related issues were common. The freedom from rehospitalization rates at 1 and 3 years was 31% and 6.9%, respectively. A total of 14 patients (10%) required device exchange.

Conclusions: Current continuous-flow left ventricular assist devices can provide satisfactory long-term survival. However, rehospitalization is frequently required.

Original languageEnglish (US)
Pages (from-to)1606-1614
Number of pages9
JournalJournal of Thoracic and Cardiovascular Surgery
Volume148
Issue number4
DOIs
StatePublished - Oct 1 2014
Externally publishedYes

Fingerprint

Heart-Assist Devices
Equipment and Supplies
Transplantation
Survival
Heart Transplantation
Complementary Therapies
Therapeutics
Hemorrhage
Technology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine
  • Medicine(all)

Cite this

Long-term outcome of patients on continuous-flow left ventricular assist device support. / Takeda, Koji; Takayama, Hiroo; Kalesan, Bindu; Uriel, Nir; Colombo, Paolo C.; Jorde, Ulrich P.; Naka, Yoshifumi.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 148, No. 4, 01.10.2014, p. 1606-1614.

Research output: Contribution to journalArticle

Takeda, Koji ; Takayama, Hiroo ; Kalesan, Bindu ; Uriel, Nir ; Colombo, Paolo C. ; Jorde, Ulrich P. ; Naka, Yoshifumi. / Long-term outcome of patients on continuous-flow left ventricular assist device support. In: Journal of Thoracic and Cardiovascular Surgery. 2014 ; Vol. 148, No. 4. pp. 1606-1614.
@article{fd8da68fe7ab4e5b8f8932003d3032cc,
title = "Long-term outcome of patients on continuous-flow left ventricular assist device support",
abstract = "Objectives: Recent advances in technology and improved patient management have enabled the use of mechanical circulatory support for unexpected long-term periods. Improved long-term outcomes may facilitate the use of device therapy as an alternative to heart transplantation. However, there are scarce data about the longterm outcomes of continuous-flow left ventricular assist devices. This study sought to evaluate the long-term outcomes in patients receiving continuous-flow left ventricular assist devices.Methods: Between March 2004 and June 2010, 140 patients underwent continuous-flow left ventricular assist device insertion as a bridge to transplantation or a destination therapy. These patients charts were retrospectively reviewed.Results: The initial strategy for continuous-flow left ventricular assist device therapy was bridge to transplantation in 115 patients (82{\%}) and destination therapy in 25 patients (18{\%}). Of those, 24 (17{\%}) died on left ventricular assist device support, 94 (67{\%}) were successfully bridged to transplantation, and 1 (0.71{\%}) showed native heart recovery. Twenty-four patients (17{\%}) had been on continuous-flow left ventricular assist device support for more than 3 years (mean, 3.9 years; range, 3.0-7.5 years). Estimated on-device survival at 1, 3, and 5 years was 83{\%}, 75{\%}, and 61{\%}, respectively. Rehospitalizations due to bleeding, cardiac events, and device-related issues were common. The freedom from rehospitalization rates at 1 and 3 years was 31{\%} and 6.9{\%}, respectively. A total of 14 patients (10{\%}) required device exchange.Conclusions: Current continuous-flow left ventricular assist devices can provide satisfactory long-term survival. However, rehospitalization is frequently required.",
author = "Koji Takeda and Hiroo Takayama and Bindu Kalesan and Nir Uriel and Colombo, {Paolo C.} and Jorde, {Ulrich P.} and Yoshifumi Naka",
year = "2014",
month = "10",
day = "1",
doi = "10.1016/j.jtcvs.2014.04.009",
language = "English (US)",
volume = "148",
pages = "1606--1614",
journal = "Journal of Thoracic and Cardiovascular Surgery",
issn = "0022-5223",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - Long-term outcome of patients on continuous-flow left ventricular assist device support

AU - Takeda, Koji

AU - Takayama, Hiroo

AU - Kalesan, Bindu

AU - Uriel, Nir

AU - Colombo, Paolo C.

AU - Jorde, Ulrich P.

AU - Naka, Yoshifumi

PY - 2014/10/1

Y1 - 2014/10/1

N2 - Objectives: Recent advances in technology and improved patient management have enabled the use of mechanical circulatory support for unexpected long-term periods. Improved long-term outcomes may facilitate the use of device therapy as an alternative to heart transplantation. However, there are scarce data about the longterm outcomes of continuous-flow left ventricular assist devices. This study sought to evaluate the long-term outcomes in patients receiving continuous-flow left ventricular assist devices.Methods: Between March 2004 and June 2010, 140 patients underwent continuous-flow left ventricular assist device insertion as a bridge to transplantation or a destination therapy. These patients charts were retrospectively reviewed.Results: The initial strategy for continuous-flow left ventricular assist device therapy was bridge to transplantation in 115 patients (82%) and destination therapy in 25 patients (18%). Of those, 24 (17%) died on left ventricular assist device support, 94 (67%) were successfully bridged to transplantation, and 1 (0.71%) showed native heart recovery. Twenty-four patients (17%) had been on continuous-flow left ventricular assist device support for more than 3 years (mean, 3.9 years; range, 3.0-7.5 years). Estimated on-device survival at 1, 3, and 5 years was 83%, 75%, and 61%, respectively. Rehospitalizations due to bleeding, cardiac events, and device-related issues were common. The freedom from rehospitalization rates at 1 and 3 years was 31% and 6.9%, respectively. A total of 14 patients (10%) required device exchange.Conclusions: Current continuous-flow left ventricular assist devices can provide satisfactory long-term survival. However, rehospitalization is frequently required.

AB - Objectives: Recent advances in technology and improved patient management have enabled the use of mechanical circulatory support for unexpected long-term periods. Improved long-term outcomes may facilitate the use of device therapy as an alternative to heart transplantation. However, there are scarce data about the longterm outcomes of continuous-flow left ventricular assist devices. This study sought to evaluate the long-term outcomes in patients receiving continuous-flow left ventricular assist devices.Methods: Between March 2004 and June 2010, 140 patients underwent continuous-flow left ventricular assist device insertion as a bridge to transplantation or a destination therapy. These patients charts were retrospectively reviewed.Results: The initial strategy for continuous-flow left ventricular assist device therapy was bridge to transplantation in 115 patients (82%) and destination therapy in 25 patients (18%). Of those, 24 (17%) died on left ventricular assist device support, 94 (67%) were successfully bridged to transplantation, and 1 (0.71%) showed native heart recovery. Twenty-four patients (17%) had been on continuous-flow left ventricular assist device support for more than 3 years (mean, 3.9 years; range, 3.0-7.5 years). Estimated on-device survival at 1, 3, and 5 years was 83%, 75%, and 61%, respectively. Rehospitalizations due to bleeding, cardiac events, and device-related issues were common. The freedom from rehospitalization rates at 1 and 3 years was 31% and 6.9%, respectively. A total of 14 patients (10%) required device exchange.Conclusions: Current continuous-flow left ventricular assist devices can provide satisfactory long-term survival. However, rehospitalization is frequently required.

UR - http://www.scopus.com/inward/record.url?scp=84908153463&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84908153463&partnerID=8YFLogxK

U2 - 10.1016/j.jtcvs.2014.04.009

DO - 10.1016/j.jtcvs.2014.04.009

M3 - Article

C2 - 25260275

AN - SCOPUS:84908153463

VL - 148

SP - 1606

EP - 1614

JO - Journal of Thoracic and Cardiovascular Surgery

JF - Journal of Thoracic and Cardiovascular Surgery

SN - 0022-5223

IS - 4

ER -