Abstract
Left ventricular assist devices (LVADs) have become a preferred treatment option for patients with end-stage heart failure when used as a bridge to transplant or as a destination therapy. However, the association between small body size and postoperative outcomes for continuous-flow (CF) LVAD recipients is still being studied. We sought to determine whether body surface area (BSA) is associated with patient outcomes after CF-LVAD implantation. The study cohort of our single-center, retrospective review consisted of all patients (n = 526) who underwent CF-LVAD implantation (n = 403 HeartMate II, n = 123 HeartWare) between November 2003 and March 2016 regardless of indication. Patients were stratified into 2 cohorts according to their BSA measurements: small BSA (<1.5 m2, n = 13) and non-small BSA (≥1.5 m2, n = 513). We compared the survival of the small-BSA cohort with that of the non-small-BSA cohort. Patients with a small BSA had lower survival rates at 1, 6, 12, and 24 months (76.9, 61.5, 53.8, and 38.5%, respectively) than did patients with a non-small BSA (90.4, 80.9, 74.7, and 67.6% respectively; overall, p = 0.004). Cox proportional hazard analysis showed that a small BSA was an independent predictor of postoperative mortality (hazard ratio = 0.22, 95% confidence interval = 0.05–0.97, p < 0.04). These findings highlight the adverse impact of a small BSA on outcomes after CF-LVAD implantation.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 31-38 |
| Number of pages | 8 |
| Journal | Journal of Artificial Organs |
| Volume | 21 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1 2018 |
| Externally published | Yes |
Fingerprint
Keywords
- Body mass index (BMI)
- Body surface area (BSA)
- Heart failure
- Left ventricular assist device (LVAD)
- Obesity
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Biomaterials
- Biomedical Engineering
- Cardiology and Cardiovascular Medicine
Cite this
Outcomes in patients with advanced heart failure and small body size undergoing continuous-flow left ventricular assist device implantation. / Volkovicher, Nastasya; Kurihara, Chitaru; Critsinelis, Andre; Kawabori, Masashi; Sugiura, Tadahisa; Manon, Marcos; Civitello, Andrew B.; Morgan, Jeffrey A.
In: Journal of Artificial Organs, Vol. 21, No. 1, 01.01.2018, p. 31-38.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Outcomes in patients with advanced heart failure and small body size undergoing continuous-flow left ventricular assist device implantation
AU - Volkovicher, Nastasya
AU - Kurihara, Chitaru
AU - Critsinelis, Andre
AU - Kawabori, Masashi
AU - Sugiura, Tadahisa
AU - Manon, Marcos
AU - Civitello, Andrew B.
AU - Morgan, Jeffrey A.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Left ventricular assist devices (LVADs) have become a preferred treatment option for patients with end-stage heart failure when used as a bridge to transplant or as a destination therapy. However, the association between small body size and postoperative outcomes for continuous-flow (CF) LVAD recipients is still being studied. We sought to determine whether body surface area (BSA) is associated with patient outcomes after CF-LVAD implantation. The study cohort of our single-center, retrospective review consisted of all patients (n = 526) who underwent CF-LVAD implantation (n = 403 HeartMate II, n = 123 HeartWare) between November 2003 and March 2016 regardless of indication. Patients were stratified into 2 cohorts according to their BSA measurements: small BSA (<1.5 m2, n = 13) and non-small BSA (≥1.5 m2, n = 513). We compared the survival of the small-BSA cohort with that of the non-small-BSA cohort. Patients with a small BSA had lower survival rates at 1, 6, 12, and 24 months (76.9, 61.5, 53.8, and 38.5%, respectively) than did patients with a non-small BSA (90.4, 80.9, 74.7, and 67.6% respectively; overall, p = 0.004). Cox proportional hazard analysis showed that a small BSA was an independent predictor of postoperative mortality (hazard ratio = 0.22, 95% confidence interval = 0.05–0.97, p < 0.04). These findings highlight the adverse impact of a small BSA on outcomes after CF-LVAD implantation.
AB - Left ventricular assist devices (LVADs) have become a preferred treatment option for patients with end-stage heart failure when used as a bridge to transplant or as a destination therapy. However, the association between small body size and postoperative outcomes for continuous-flow (CF) LVAD recipients is still being studied. We sought to determine whether body surface area (BSA) is associated with patient outcomes after CF-LVAD implantation. The study cohort of our single-center, retrospective review consisted of all patients (n = 526) who underwent CF-LVAD implantation (n = 403 HeartMate II, n = 123 HeartWare) between November 2003 and March 2016 regardless of indication. Patients were stratified into 2 cohorts according to their BSA measurements: small BSA (<1.5 m2, n = 13) and non-small BSA (≥1.5 m2, n = 513). We compared the survival of the small-BSA cohort with that of the non-small-BSA cohort. Patients with a small BSA had lower survival rates at 1, 6, 12, and 24 months (76.9, 61.5, 53.8, and 38.5%, respectively) than did patients with a non-small BSA (90.4, 80.9, 74.7, and 67.6% respectively; overall, p = 0.004). Cox proportional hazard analysis showed that a small BSA was an independent predictor of postoperative mortality (hazard ratio = 0.22, 95% confidence interval = 0.05–0.97, p < 0.04). These findings highlight the adverse impact of a small BSA on outcomes after CF-LVAD implantation.
KW - Body mass index (BMI)
KW - Body surface area (BSA)
KW - Heart failure
KW - Left ventricular assist device (LVAD)
KW - Obesity
UR - http://www.scopus.com/inward/record.url?scp=85029594767&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85029594767&partnerID=8YFLogxK
U2 - 10.1007/s10047-017-0988-z
DO - 10.1007/s10047-017-0988-z
M3 - Article
C2 - 28932915
AN - SCOPUS:85029594767
VL - 21
SP - 31
EP - 38
JO - Journal of Artificial Organs
JF - Journal of Artificial Organs
SN - 1434-7229
IS - 1
ER -