Outcomes in patients with advanced heart failure and small body size undergoing continuous-flow left ventricular assist device implantation

Nastasya Volkovicher, Chitaru Kurihara, Andre Critsinelis, Masashi Kawabori, Tadahisa Sugiura, Marcos Manon, Andrew B. Civitello, Jeffrey A. Morgan

Research output: Contribution to journalArticle

2 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)31-38
Number of pages8
JournalJournal of Artificial Organs
Volume21
Issue number1
DOIs
StatePublished - Jan 1 2018
Externally publishedYes

Fingerprint

Left ventricular assist devices
Heart-Assist Devices
Body Surface Area
Body Size
Heart Failure
Hazards
Transplants
Cohort Studies
Survival Rate

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 journalArticle

Volkovicher, Nastasya ; Kurihara, Chitaru ; Critsinelis, Andre ; Kawabori, Masashi ; Sugiura, Tadahisa ; Manon, Marcos ; Civitello, Andrew B. ; Morgan, Jeffrey A. / Outcomes in patients with advanced heart failure and small body size undergoing continuous-flow left ventricular assist device implantation. In: Journal of Artificial Organs. 2018 ; Vol. 21, No. 1. pp. 31-38.
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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.",
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