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- Title
Single-centre experience of 85 patients with a continuous-flow left ventricular assist device: clinical practice and outcome after extended support.
- Authors
Lok, Sjoukje I.; Martina, Jerson R.; Hesselink, Tim; Rodermans, Ben F.M.; Hulstein, Nelienke; Winkens, Bjorn; Klöpping, Corinne; Kirkels, J. Hans; Doevendans, Pieter A.; Ramjankhan, Faiz; de Weger, Roel A.; de Jonge, Nicolaas; Lahpor, Jaap R.
- Abstract
OBJECTIVES We evaluated our single-centre clinical experience with the HeartMate II (HM II) left ventricular assist device (LVAD) as a bridge to transplantation (BTT) in end-stage heart failure (HF) patients. METHODS Survival rates, echocardiographic parameters, laboratory values and adverse events of 85 consecutive patients supported with a HM II were evaluated. RESULTS Overall, mean age was 45 ± 13 years, 62 (73%) were male and non-ischaemic dilatated cardiomyopathy was present in 60 (71%) patients. The median duration of mechanical support was 387 days (IQR 150–600), with a range of 1–1835 days. The 6-month, 1-, 2-, 3- and 4-year survival rates during HM II LVAD support were 85, 81, 76, 76 and 68%, respectively. Echocardiographic parameters demonstrated effective left ventricular unloading, while laboratory results reflected adequate organ perfusion. However, HM II support was associated with adverse events, such as infections in 42 patients (49%; 0.67 events/patient-year), cardiac arrhythmia in 44 (52%; 0.86 events/patient-year), bleeding complications in 32 (38%; 0.43 events/patient-year) and neurological dysfunction in 17 (20%; 0.19 events/patient-year). CONCLUSIONS In view of the increasing shortage of donor hearts, HM II LVAD support may be considered a life-saving treatment in end-stage HF patients, with good survival. However, it is still associated with some serious adverse events, of which neurological complications are the most critical.
- Subjects
HEART assist devices; LEFT heart ventricle surgery; HEART transplantation; ECHOCARDIOGRAPHY; MEDICAL equipment; CLINICAL trials; HEALTH outcome assessment
- Publication
European Journal of Cardio-Thoracic Surgery, 2013, Vol 44, Issue 3, pe233
- ISSN
1010-7940
- Publication type
Article
- DOI
10.1093/ejcts/ezt347