Outcomes on Continuous Flow Left Ventricular Assist Devices: A Single Institutional 9-Year Experience

Area of Science:

• Cardiology
• Medical Devices
• Heart Failure Management

Background:

• Continuous-flow left ventricular assist devices (CF LVADs) are standard for advanced heart failure.
• A 9-year institutional experience with CF LVADs is reviewed.

Purpose of the Study:

• To evaluate the institutional experience with CF LVADs over nine years.
• To assess survival rates and complications in patients receiving CF LVADs for bridge to transplantation (BTT) and destination therapy (DT).

Main Methods:

• A retrospective review of 231 patients who received 240 CF LVADs (HeartMate II or HVAD) from March 2006 to May 2015.
• Patients were categorized into BTT (n=127) and DT (n=113) groups.
• Analysis included patient demographics, preoperative conditions, survival rates, and postoperative complications.

Main Results:

• DT patients were older and had more comorbidities than BTT patients.
• 1- and 2-year survival rates were higher for BTT patients (91.0% and 72.1%) compared to DT patients (85.3% and 59.0%).
• Gastrointestinal bleeding, right ventricular failure, and stroke were the most common complications. Preoperative liver biopsy and elevated liver enzymes were independent predictors of survival.

Conclusions:

• Long-term LVAD support demonstrates excellent survival for both BTT and DT patients.
• Further reduction in postoperative complications is necessary for LVADs to be a more widely accepted alternative to heart transplantation.