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5-year results of a newly implemented mechanical circulatory support program for terminal heart failure patients in a Swiss non-cardiac transplant university hospital.
- Source :
-
Journal of Cardiothoracic Surgery . 3/31/2021, Vol. 16 Issue 1, p1-10. 10p. - Publication Year :
- 2021
-
Abstract
- <bold>Background: </bold>In Switzerland, long-term circulatory support programs have been limited to heart transplant centers. In 2014, to improve the management of patients with end-stage heart failure not eligible for transplantation, we implemented a left ventricular assist device (LVAD) program for destination therapy at the University Hospital of Basel.<bold>Methods: </bold>We described the program set-up with practical aspects. Patients aged 65 and above with therapy refractory end-stage heart failure without major contraindication for LVAD implantation were included. Younger patients with bridge-to-candidacy profile were also considered. Using the Kaplan-Meier estimate, we retrospectively analyzed the overall survival and freedom from major adverse events after LVAD implantation. We compared our results to internationally reported data.<bold>Results: </bold>Between October 2014 and September 2019, 16 patients received an LVAD in our center. The mean age at implantation was 67.1 years. The mean EuroSCORE II was 24.4% and the median INTERMACS level was 4. Thirteen patients received an LVAD as destination therapy and three patients as bridge-to-candidacy. The overall survival was 87.5 and 70% at 1 and 2 years, respectively. Freedom from stroke was 81.3% at 1 and 2 years. Freedom from device infection was 67.7 and 58.7% at 1 and 2 years, respectively. Freedom from gastrointestinal bleeding was 75 and 56.3% at 1 and 2 years, respectively. Freedom from readmission was 50 and 31.3% and at 6 months and 1 year, respectively.<bold>Conclusions: </bold>The Basel experience demonstrated the possible implementation of an LVAD program for destination therapy or bridge-to-candidacy in a non-transplant comprehensive heart-failure center with midterm survival results and freedom from major adverse events comparable to international registries. Patient selection remains crucial.<bold>Trial Registration: </bold>This study was registered on the ClinicalTrials.gov database ( NCT04263012 ). [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 17498090
- Volume :
- 16
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Journal of Cardiothoracic Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 149572618
- Full Text :
- https://doi.org/10.1186/s13019-021-01447-5