Outcomes of Adult Patients with Small Body Size Supported with a Continuous-Flow Left Ventricular Assist Device: Small Adult BSA Patients and CF-LVADs

Sangjin Lee, Jason N. Katz, Ulrich P. Jorde, Nader Moazami, Ranjit John, Kartik S. Sundareswaran, David J. Farrar, O. H. Frazier

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

There is insufficient data on patients with small body size to determine if this should be considered a risk factor for continuous-flow left ventricular assist device (CF-LVAD) support. We sought to evaluate survival outcomes, adverse events, and functional status of CF-LVAD patients with body surface area (BSA)<1.5 m in a large national registry. Adults with BSA<1.5 m (n=128) implanted with a HeartMate II (HMII)-LVAD from the INTERMACs registry from April 2008 to December 2012 formed this cohort. Outcomes were compared to HMII Bridge to Transplant (BTT) and Destination Therapy (DT) Post-Approval Studies. The majority of patients were female (n=106, 83%). 64% (n=82) were implanted for BTT and 36% (n=46) DT. The median BSA (range) was 1.44 (1.19-1.49) and 1.45 (1.25-1.49) m for BTT and DT respectively. Overall survival one year post-implant was 81 ± 5% for BTT and 84 ± 6% for DT. The most common adverse events for BTT and DT patients were bleeding (0.91, 0.88 events/patient year) and driveline infection (16%, 0.28 events/patient year). Six months post-implantation, 87% of BTT and 77% of DT patients were NYHA functional class I or II. Post-implant survival, functional status improvement, and adverse event profile for adult BTT and DT HMII patients with BSA<1.5 m are favorable and comparable to outcomes published in the overall patient population.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.

Original languageEnglish (US)
JournalASAIO Journal
DOIs
StateAccepted/In press - Aug 22 2016

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Left ventricular assist devices
Transplants
Heart-Assist Devices
Body Surface Area
Body Size
Therapeutics
Survival
Registries
Licensure
Derivatives
Hemorrhage

ASJC Scopus subject areas

  • Biophysics
  • Bioengineering
  • Biomaterials
  • Medicine(all)
  • Biomedical Engineering

Cite this

Outcomes of Adult Patients with Small Body Size Supported with a Continuous-Flow Left Ventricular Assist Device : Small Adult BSA Patients and CF-LVADs. / Lee, Sangjin; Katz, Jason N.; Jorde, Ulrich P.; Moazami, Nader; John, Ranjit; Sundareswaran, Kartik S.; Farrar, David J.; Frazier, O. H.

In: ASAIO Journal, 22.08.2016.

Research output: Contribution to journalArticle

Lee, Sangjin ; Katz, Jason N. ; Jorde, Ulrich P. ; Moazami, Nader ; John, Ranjit ; Sundareswaran, Kartik S. ; Farrar, David J. ; Frazier, O. H. / Outcomes of Adult Patients with Small Body Size Supported with a Continuous-Flow Left Ventricular Assist Device : Small Adult BSA Patients and CF-LVADs. In: ASAIO Journal. 2016.
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abstract = "There is insufficient data on patients with small body size to determine if this should be considered a risk factor for continuous-flow left ventricular assist device (CF-LVAD) support. We sought to evaluate survival outcomes, adverse events, and functional status of CF-LVAD patients with body surface area (BSA)<1.5 m in a large national registry. Adults with BSA<1.5 m (n=128) implanted with a HeartMate II (HMII)-LVAD from the INTERMACs registry from April 2008 to December 2012 formed this cohort. Outcomes were compared to HMII Bridge to Transplant (BTT) and Destination Therapy (DT) Post-Approval Studies. The majority of patients were female (n=106, 83{\%}). 64{\%} (n=82) were implanted for BTT and 36{\%} (n=46) DT. The median BSA (range) was 1.44 (1.19-1.49) and 1.45 (1.25-1.49) m for BTT and DT respectively. Overall survival one year post-implant was 81 ± 5{\%} for BTT and 84 ± 6{\%} for DT. The most common adverse events for BTT and DT patients were bleeding (0.91, 0.88 events/patient year) and driveline infection (16{\%}, 0.28 events/patient year). Six months post-implantation, 87{\%} of BTT and 77{\%} of DT patients were NYHA functional class I or II. Post-implant survival, functional status improvement, and adverse event profile for adult BTT and DT HMII patients with BSA<1.5 m are favorable and comparable to outcomes published in the overall patient population.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.",
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