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Outcomes and Predictors of Early Mortality After Continuous-Flow Left Ventricular Assist Device Implantation as a Bridge to Transplantation
Left ventricular assist devices (LVADs) are fast becoming standard of care for patients with advanced heart failure. However, despite continuous improvement in VAD technology, there remains a significant early postoperative morbidity and mortality in this extreme patient group. The aim of the curren...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3942348/ https://www.ncbi.nlm.nih.gov/pubmed/24399066 http://dx.doi.org/10.1097/MAT.0000000000000035 |
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author | Sabashnikov, Anton Mohite, Prashant N. Zych, Bartlomiej García, Diana Popov, Aron-Frederik Weymann, Alexander Patil, Nikhil P. Hards, Rachel Capoccia, Massimo Wahlers, Thorsten De Robertis, Fabio Bahrami, Toufan Amrani, Mohamed Banner, Nicholas R. Simon, André R. |
author_facet | Sabashnikov, Anton Mohite, Prashant N. Zych, Bartlomiej García, Diana Popov, Aron-Frederik Weymann, Alexander Patil, Nikhil P. Hards, Rachel Capoccia, Massimo Wahlers, Thorsten De Robertis, Fabio Bahrami, Toufan Amrani, Mohamed Banner, Nicholas R. Simon, André R. |
author_sort | Sabashnikov, Anton |
collection | PubMed |
description | Left ventricular assist devices (LVADs) are fast becoming standard of care for patients with advanced heart failure. However, despite continuous improvement in VAD technology, there remains a significant early postoperative morbidity and mortality in this extreme patient group. The aim of the current study was to explore the short-term outcomes and predictors for 90 day mortality in the patients after implantation of continuous-flow LVAD. Perioperative clinical, echocardiographic, hemodynamic, and laboratory data of 90 day survivors and nonsurvivors were collected and compared retrospectively. Multivariate logistic regression analysis was performed on univariate predictors for 90 day mortality with an entry criterion of p < 0.1. Between July 2006 and May 2012, 117 patients underwent implantation of a continuous-flow LVAD as a bridge to transplantation: 71 (60.7%) HeartMate II (Thoratec Corp, Pleasanton, CA) and 46 (39.3%) HVAD (HeartWare International, Framingham, MA). All-cause 90 day mortality was 17.1%. Multivariate analysis revealed higher preoperative central venous pressure (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.014–1.378; p = 0.033) and higher age (OR, 1.14; 95% CI, 1.01–1.38; p = 0.045) as the only independent predictors for 90 day mortality. Optimization of preoperative volume status, preload, and right heart function as well as age-based selection of candidates for LVAD support are the critical factors influencing early outcome after continuous-flow LVAD implantation. |
format | Online Article Text |
id | pubmed-3942348 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-39423482014-03-05 Outcomes and Predictors of Early Mortality After Continuous-Flow Left Ventricular Assist Device Implantation as a Bridge to Transplantation Sabashnikov, Anton Mohite, Prashant N. Zych, Bartlomiej García, Diana Popov, Aron-Frederik Weymann, Alexander Patil, Nikhil P. Hards, Rachel Capoccia, Massimo Wahlers, Thorsten De Robertis, Fabio Bahrami, Toufan Amrani, Mohamed Banner, Nicholas R. Simon, André R. ASAIO J Adult Circulatory Support Left ventricular assist devices (LVADs) are fast becoming standard of care for patients with advanced heart failure. However, despite continuous improvement in VAD technology, there remains a significant early postoperative morbidity and mortality in this extreme patient group. The aim of the current study was to explore the short-term outcomes and predictors for 90 day mortality in the patients after implantation of continuous-flow LVAD. Perioperative clinical, echocardiographic, hemodynamic, and laboratory data of 90 day survivors and nonsurvivors were collected and compared retrospectively. Multivariate logistic regression analysis was performed on univariate predictors for 90 day mortality with an entry criterion of p < 0.1. Between July 2006 and May 2012, 117 patients underwent implantation of a continuous-flow LVAD as a bridge to transplantation: 71 (60.7%) HeartMate II (Thoratec Corp, Pleasanton, CA) and 46 (39.3%) HVAD (HeartWare International, Framingham, MA). All-cause 90 day mortality was 17.1%. Multivariate analysis revealed higher preoperative central venous pressure (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.014–1.378; p = 0.033) and higher age (OR, 1.14; 95% CI, 1.01–1.38; p = 0.045) as the only independent predictors for 90 day mortality. Optimization of preoperative volume status, preload, and right heart function as well as age-based selection of candidates for LVAD support are the critical factors influencing early outcome after continuous-flow LVAD implantation. Lippincott Williams & Wilkins 2014-03 2014-02-28 /pmc/articles/PMC3942348/ /pubmed/24399066 http://dx.doi.org/10.1097/MAT.0000000000000035 Text en Copyright © 2014 by the American Society for Artificial Internal Organs http://creativecommons.org/licenses/by-nc-nd/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivitives 3.0 License, 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. |
spellingShingle | Adult Circulatory Support Sabashnikov, Anton Mohite, Prashant N. Zych, Bartlomiej García, Diana Popov, Aron-Frederik Weymann, Alexander Patil, Nikhil P. Hards, Rachel Capoccia, Massimo Wahlers, Thorsten De Robertis, Fabio Bahrami, Toufan Amrani, Mohamed Banner, Nicholas R. Simon, André R. Outcomes and Predictors of Early Mortality After Continuous-Flow Left Ventricular Assist Device Implantation as a Bridge to Transplantation |
title | Outcomes and Predictors of Early Mortality After Continuous-Flow Left Ventricular Assist Device Implantation as a Bridge to Transplantation |
title_full | Outcomes and Predictors of Early Mortality After Continuous-Flow Left Ventricular Assist Device Implantation as a Bridge to Transplantation |
title_fullStr | Outcomes and Predictors of Early Mortality After Continuous-Flow Left Ventricular Assist Device Implantation as a Bridge to Transplantation |
title_full_unstemmed | Outcomes and Predictors of Early Mortality After Continuous-Flow Left Ventricular Assist Device Implantation as a Bridge to Transplantation |
title_short | Outcomes and Predictors of Early Mortality After Continuous-Flow Left Ventricular Assist Device Implantation as a Bridge to Transplantation |
title_sort | outcomes and predictors of early mortality after continuous-flow left ventricular assist device implantation as a bridge to transplantation |
topic | Adult Circulatory Support |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3942348/ https://www.ncbi.nlm.nih.gov/pubmed/24399066 http://dx.doi.org/10.1097/MAT.0000000000000035 |
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