TY - JOUR
T1 - Single-centre experience of 85 patients with a continuous-flow left ventricular assist device
T2 - clinical practice and outcome after extended support
AU - Lok, S.I.
AU - Martina, J.R.
AU - Hesselink, T.
AU - Rodermans, B.F.M.
AU - Hulstein, N.
AU - Winkens, B.
AU - Klöpping, C.
AU - Kirkels, J.H.
AU - Doevendans, P.A.F.M.
AU - Ramjankhan, F.Z.
AU - de Weger, R.A.
AU - de Jonge, N.
AU - Lahpor, JR
PY - 2013/9
Y1 - 2013/9
N2 - 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.Survival rates, echocardiographic parameters, laboratory values and adverse events of 85 consecutive patients supported with a HM II were evaluated.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).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.
AB - 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.Survival rates, echocardiographic parameters, laboratory values and adverse events of 85 consecutive patients supported with a HM II were evaluated.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).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.
KW - Continuous-flow LVAD
KW - HeartMate II
KW - Survival
KW - Adverse events
KW - HEART-FAILURE
KW - IMPLANTATION
KW - TRANSPLANTATION
KW - RECOVERY
KW - BRIDGE
U2 - 10.1093/ejcts/ezt347
DO - 10.1093/ejcts/ezt347
M3 - Article
C2 - 23868955
SN - 1010-7940
VL - 44
SP - E233-E238
JO - European Journal of Cardio-thoracic Surgery
JF - European Journal of Cardio-thoracic Surgery
IS - 3
ER -