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Comparative analysis of regional outcomes and adverse events after continuous-flow left ventricular assist device implantation: An IMACS analysis
- Source :
- The Journal of Heart and Lung Transplantation. 39:904-914
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- INTRODUCTION: Regional outcomes after implantation of continuous-flow left ventricular assist devices (LVADs) have not been described. We examined differences in patient selection, survival, and adverse events across 3 geographic regions of the world: the Americas, Asia-Pacific, and Europe. METHODS: Using data from The International Society for Heart and Lung Transplantation Mechanically Assisted Circulatory Support registry, all adult patients implanted with a continuous-flow LVADs were included in this International Society for Heart and Lung Transplantation Mechanically Assisted Circulatory Support analysis (n = 15,560), of whom, 9,988 (64%) received axial-flow devices and 5,572 (36%) received centrifugal-flow devices. RESULTS: There were significant interregional differences in the rate of implantation of patients aged >70 years (Americas: 14%, Asia-Pacific: 1%, Europe: 5%; p < 0.0001), morbidly obese (Americas: 5%, Asia-Pacific: 1%, Europe: 1%; p < 0.0001), male (Americas: 79%, Asia-Pacific: 77%, Europe: 85%; p < 0.0001), and implanted as destination therapy (Americas: 48%, Asia-Pacific: 4%, Europe: 22%; p < 0.0001). The rates of centrifugal pump usage varied by region (Americas: 30%, Asia-Pacific: 34%, Eu: 74%; p < 0.0001). Survival rates varied by region and the type of pump flow, with survival at 12 and 48 months (axial flow vs centrifugal flow) being 82% vs 82% and 52% vs 53 in Americas; 92% vs 86% and 83% vs 74% in Asia-Pacific; and 80% vs 75% and 69% vs 53% in Europe, respectively (regional survival p < 0.0001). CONCLUSION: There are marked global differences in LVAD recipient characteristics, device utilization, and post-operative care. These heterogeneities along with differences in patient management and transplantation rates may impact long-term survival. Regional differences in adverse event incidence warrant further investigation. ispartof: JOURNAL OF HEART AND LUNG TRANSPLANTATION vol:39 issue:9 pages:904-914 ispartof: location:United States status: published
- Subjects :
- Male
Cardiac & Cardiovascular Systems
IMPACT
medicine.medical_treatment
Respiratory System
030204 cardiovascular system & hematology
030230 surgery
Global Health
BRIDGE
0302 clinical medicine
Registries
Incidence (epidemiology)
MECHANICAL CIRCULATORY SUPPORT
Middle Aged
Europe
Survival Rate
Treatment Outcome
Circulatory system
outcome
Cardiology
Female
Cardiology and Cardiovascular Medicine
Life Sciences & Biomedicine
Adult
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Adolescent
HEART-TRANSPLANTATION
Young Adult
03 medical and health sciences
Internal medicine
left ventricular assist device
medicine
continuous flow
Humans
Lung transplantation
In patient
Adverse effect
Aged
Retrospective Studies
Heart Failure
Transplantation
Science & Technology
business.industry
Continuous flow
Asia-Pacific
MOMENTUM
BODY-MASS INDEX
CENTRIFUGAL
REGISTRY
Ventricular assist device
Cardiovascular System & Cardiology
Surgery
Heart-Assist Devices
Americas
business
Subjects
Details
- ISSN :
- 10532498
- Volume :
- 39
- Database :
- OpenAIRE
- Journal :
- The Journal of Heart and Lung Transplantation
- Accession number :
- edsair.doi.dedup.....437a3567ec4fa7a4a0c893d80a5cb15a