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Changes in End-Organ Function in Patients With Prolonged Continuous-Flow Left Ventricular Assist Device Support.
Daisuke Yoshioka1, Hiroo Takayama1, Paolo C Colombo2
1Division of Cardiothoracic Surgery, Columbia University Medical Center, New York, New York.
The Annals of Thoracic Surgery
|February 8, 2017
Summary
Continuous-flow left ventricular assist devices (LVADs) improve organ function initially. However, renal function gains are mostly temporary, returning to baseline after long-term LVAD support.
Area of Science:
- Cardiology
- Medical Devices
- Organ Function
Background:
- Limited data exists on long-term end-organ function with continuous-flow ventricular assist devices.
- Reduced pulsatility from continuous flow may impact organ perfusion and function over time.
Purpose of the Study:
- To evaluate the long-term effects of continuous-flow left ventricular assist device (LVAD) support on renal and hepatic function.
- To identify risk factors associated with declining renal function during prolonged LVAD support.
Main Methods:
- Retrospective analysis of 59 patients receiving continuous-flow LVAD for at least 3 years.
- Assessment of renal and hepatic function at multiple postoperative time points up to 3 years.
Main Results:
- Significant initial improvements in renal and hepatic function observed at 1 month post-LVAD implantation.
- Hepatic function remained stable within normal ranges for up to 3 years.
- Renal function improvement was transient, with most patients experiencing a decline back to baseline eGFR by 3 years. Risk factors included older age, ischemic heart failure, and right heart failure.
Conclusions:
- Continuous-flow LVADs offer initial benefits for renal and hepatic function in advanced heart failure.
- The renal function improvement is largely transient, necessitating further research into long-term renal outcomes and management strategies.
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