1. Durable left ventricular assist devices following temporary circulatory support on a microaxial flow pump with and without extracorporeal life supportCentral MessagePerspective
- Author
-
Daniel Lewin, Sebastian V. Rojas, MD, Michael Billion, MD, Anna L. Meyer, MD, Ivan Netuka, MD, Janajade Kooij, MD, Marina Pieri, MD, Antonio Loforte, MD, Mariusz K. Szymanski, MD, Christian H. Moeller, MD, Payam Akhyari, MD, Khalil Jawad, MD, Ihor Krasivskyi, MD, Bastian Schmack, MD, Gloria Färber, MD, Marta Medina, MD, Assad Haneya, MD, Daniel Zimpfer, MD, Gaik Nersesian, MD, Mehmet Oezkur, MD, Ilija Djordjevic, MD, Diyar Saeed, MD, Julia Stein, Adriaan O. Kraaijeveld, MD, Finn Gustafsson, MD, Mara Scandroglio, MD, Bart Meyns, MD, Steffen Hofmann, MD, Jan Belohlavek, MD, Jan F. Gummert, MD, Pia Lanmueller, MD, Alexander M. Bernhardt, MD, and Evgenij V. Potapov, MD
- Subjects
cardiogenic shock ,mechanical circulatory support ,Impella ,LVAD ,outcome ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 ,Surgery ,RD1-811 - Abstract
Background: Circulatory support with a catheter-based microaxial flow pump (mAFP) plays a major role in the treatment of severe cardiogenic shock. In most patients who fail to recover while on temporary mechanical circulatory support (tMCS) and who are not eligible for heart transplantation, durable left ventricular assist device (dLVAD) implantation is usually considered a reliable option. This study aimed to describe the outcome of dLVAD therapy following mAFP support and to identify predictors of mortality. Methods: This was a retrospective analysis of data from a multicenter registry on patients who underwent dLVAD implantation following tMCS with a mAFP between January 2017 and October 2022 (n = 332) from 19 European centers. Results: Patients were supported with an Impella 5.5 (n = 92), 5.0 (n = 153) or CP (n = 87) and were transitioned to a HeartWare HVAD (n = 128) or Heartmate 3 (n = 204) during the same period. One hundred and twenty-five patients (39.2%) also required extracorporeal life support before and/or during mAFP therapy. The 30-day and 1-year survival were 87.8% and 71.1%, respectively. The following risk factors for 1-year mortality were identified: age (odds ratio [OR], 1.02), specifically age over 55 years (OR, 1.09), body mass index >30 kg/m2 (OR, 2.2), female sex (OR for male sex, 0.43), elevated total bilirubin (OR, 1.12), and low platelet count (OR, 0.996). Conclusions: Based on the identified risk factors, a risk score for estimating 1-year mortality was calculated to optimize patient selection for dLVAD implantation.
- Published
- 2024
- Full Text
- View/download PDF