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Insertion, Maintenance, and Removal of the Percutaneous Dual Lumen Cannula Right Ventricular Assist Device
Published on: July 20, 2022
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Left Ventricular Assist Devices in Patients With Active Malignancies
Ilana Schlam1,2, Andy Y Lee3, Song Li3
1MedStar Washington Cancer Institute, Washington, DC, USA.
JACC. Cardiooncology
|August 16, 2021
Summary
Managing active cancer in patients with a left ventricular assist device (LVAD) is complex. This study found cancer diagnosis increased mortality risk but did not significantly alter survival, with fewer GI bleeds observed.
Area of Science:
- Cardiology
- Oncology
- Medical Devices
Background:
- Limited data exists for managing concurrent active malignancy in patients with left ventricular assist devices (LVADs).
- Multidisciplinary decision-making between oncology and cardiology is crucial for this patient population.
Purpose of the Study:
- To describe cancer treatment strategies, complications, and survival outcomes for patients with active cancer receiving LVAD support.
- To establish a framework for managing these complex patients in specialized heart failure and oncology programs.
Main Methods:
- Retrospective cohort study of 22 patients with LVADs and active cancer, matched 3:1 with non-cancer comparators.
- Analysis included Kaplan-Meier survival estimates and Cox proportional hazards models.
- Data collected from LVAD databases between 2005 and 2019.
Main Results:
- Cancer diagnosis was associated with a significant increase in death (HR: 2.05; P=0.04).
- No significant difference in unadjusted median survival between cancer and non-cancer groups (3.53 vs. 3.03 years).
- Patients with cancer experienced less gastrointestinal bleeding (P=0.016).
Conclusions:
- This study provides initial feasibility and safety data for managing cancer in LVAD patients.
- A multidisciplinary team approach is essential for optimal patient care.
- Further research is needed to refine treatment protocols.
Keywords:
CI, confidence intervalCMP, cardiomyopathyCTCAE, common terminology criteria for adverse eventsCVD, cardiovascular diseaseDT, destination therapyGI, gastrointestinalHF, heart failureLVAD, left ventricular assist deviceadvanced heart failurecancercancer therapiesleft ventricular assist device
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