Abstract
Objective This study assessed the early and late outcomes after cardiac transplantation in patients receiving long-term continuous-flow left ventricular assist device (CF-LVAD) support.
Methods Between April 2004 and September 2013, 192 patients underwent HeartMate II (Thoratec, Pleasanton, CA) CF-LVAD placement as a bridge to transplant at our center. Of these, 122 (63%) successfully bridged patients were retrospectively reviewed. Patients were stratified into 2 groups according to their waiting time with CF-LVAD support of <1 year or ≥1 year.
Results The study cohort was a mean age of 54 ± 13 years, 79% were male, and 35% had an ischemic etiology. The mean duration of CF-LVAD support before transplantation was 296 days (range, 27-1,413 days). The overall 30-day mortality was 4.1%. Overall post-transplant survival was 88%, 84%, 78% at 1, 3, and 5 years, respectively. The 32 patients (26%) with ≥1 year of CF-LVAD support (mean, 635 days) were more likely to have blood type O, a larger body size, and to have been readmitted due to recurrent heart failure and device failure requiring exchange than those with <1 year of CF-LVAD support. Patients who required prolonged support time also had worse in-hospital mortality (16% vs 6.7%, p = 0.12) and significantly lower survival at 3 years after transplantation (68% vs 88%, p = 0.049).
Conclusions The overall short-term and long-term cardiac transplant outcomes of patients supported with CF-LVAD are satisfactory. However, patients who require prolonged CF-LVAD support may have diminished post-transplant survival due to adverse events occurring during device support.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 89-99 |
| Number of pages | 11 |
| Journal | Journal of Heart and Lung Transplantation |
| Volume | 34 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1 2015 |
| Externally published | Yes |
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Keywords
- continuous flow
- KeyWords ventricular assist device
- long-term
- outcome
- transplant
ASJC Scopus subject areas
- Transplantation
- Cardiology and Cardiovascular Medicine
- Pulmonary and Respiratory Medicine
- Surgery
- Medicine(all)
Cite this
Outcome of cardiac transplantation in patients requiring prolonged continuous-flow left ventricular assist device support. / Takeda, Koji; Takayama, Hiroo; Kalesan, Bindu; Uriel, Nir; Colombo, Paolo C.; Jorde, Ulrich P.; Yuzefpolskaya, Melana; Mancini, Donna M.; Naka, Yoshifumi.
In: Journal of Heart and Lung Transplantation, Vol. 34, No. 1, 01.01.2015, p. 89-99.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Outcome of cardiac transplantation in patients requiring prolonged 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 - Yuzefpolskaya, Melana
AU - Mancini, Donna M.
AU - Naka, Yoshifumi
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Objective This study assessed the early and late outcomes after cardiac transplantation in patients receiving long-term continuous-flow left ventricular assist device (CF-LVAD) support.Methods Between April 2004 and September 2013, 192 patients underwent HeartMate II (Thoratec, Pleasanton, CA) CF-LVAD placement as a bridge to transplant at our center. Of these, 122 (63%) successfully bridged patients were retrospectively reviewed. Patients were stratified into 2 groups according to their waiting time with CF-LVAD support of <1 year or ≥1 year.Results The study cohort was a mean age of 54 ± 13 years, 79% were male, and 35% had an ischemic etiology. The mean duration of CF-LVAD support before transplantation was 296 days (range, 27-1,413 days). The overall 30-day mortality was 4.1%. Overall post-transplant survival was 88%, 84%, 78% at 1, 3, and 5 years, respectively. The 32 patients (26%) with ≥1 year of CF-LVAD support (mean, 635 days) were more likely to have blood type O, a larger body size, and to have been readmitted due to recurrent heart failure and device failure requiring exchange than those with <1 year of CF-LVAD support. Patients who required prolonged support time also had worse in-hospital mortality (16% vs 6.7%, p = 0.12) and significantly lower survival at 3 years after transplantation (68% vs 88%, p = 0.049).Conclusions The overall short-term and long-term cardiac transplant outcomes of patients supported with CF-LVAD are satisfactory. However, patients who require prolonged CF-LVAD support may have diminished post-transplant survival due to adverse events occurring during device support.
AB - Objective This study assessed the early and late outcomes after cardiac transplantation in patients receiving long-term continuous-flow left ventricular assist device (CF-LVAD) support.Methods Between April 2004 and September 2013, 192 patients underwent HeartMate II (Thoratec, Pleasanton, CA) CF-LVAD placement as a bridge to transplant at our center. Of these, 122 (63%) successfully bridged patients were retrospectively reviewed. Patients were stratified into 2 groups according to their waiting time with CF-LVAD support of <1 year or ≥1 year.Results The study cohort was a mean age of 54 ± 13 years, 79% were male, and 35% had an ischemic etiology. The mean duration of CF-LVAD support before transplantation was 296 days (range, 27-1,413 days). The overall 30-day mortality was 4.1%. Overall post-transplant survival was 88%, 84%, 78% at 1, 3, and 5 years, respectively. The 32 patients (26%) with ≥1 year of CF-LVAD support (mean, 635 days) were more likely to have blood type O, a larger body size, and to have been readmitted due to recurrent heart failure and device failure requiring exchange than those with <1 year of CF-LVAD support. Patients who required prolonged support time also had worse in-hospital mortality (16% vs 6.7%, p = 0.12) and significantly lower survival at 3 years after transplantation (68% vs 88%, p = 0.049).Conclusions The overall short-term and long-term cardiac transplant outcomes of patients supported with CF-LVAD are satisfactory. However, patients who require prolonged CF-LVAD support may have diminished post-transplant survival due to adverse events occurring during device support.
KW - continuous flow
KW - KeyWords ventricular assist device
KW - long-term
KW - outcome
KW - transplant
UR - http://www.scopus.com/inward/record.url?scp=84920042273&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84920042273&partnerID=8YFLogxK
U2 - 10.1016/j.healun.2014.09.007
DO - 10.1016/j.healun.2014.09.007
M3 - Article
VL - 34
SP - 89
EP - 99
JO - Journal of Heart and Lung Transplantation
JF - Journal of Heart and Lung Transplantation
SN - 1053-2498
IS - 1
ER -