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Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
Published on: August 16, 2021
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Continuous-Flow Left Ventricular Assist Device Support in Patients with Ischemic Versus Nonischemic Cardiomyopathy.
Brendan P Chou1, Andre Critsinelis1, Harveen K Lamba1
1Division of Cardiothoracic Transplantation and Circulatory Support, Baylor College of Medicine, Houston, Texas.
Texas Heart Institute Journal
|September 1, 2021
Summary
The cause of cardiomyopathy did not affect survival in patients receiving continuous-flow left ventricular assist device support. However, ischemic cardiomyopathy patients experienced more gastrointestinal bleeding, impacting their care.
Area of Science:
- Cardiology
- Mechanical Circulatory Support
Background:
- Continuous-flow left ventricular assist devices (CF-LVADs) are crucial for end-stage heart failure.
- Understanding how cardiomyopathy etiology influences outcomes in CF-LVAD patients is vital for personalized care.
Purpose of the Study:
- To compare postimplant adverse events and survival in patients with ischemic versus nonischemic cardiomyopathy undergoing CF-LVAD support.
- To identify factors predicting mortality in CF-LVAD recipients.
Main Methods:
- Retrospective analysis of 526 patients (256 ischemic, 270 nonischemic) receiving CF-LVADs from 2003-2016.
- Comparison of adverse events (e.g., gastrointestinal bleeding) and survival rates between the two groups.
- Kaplan-Meier survival analysis and multivariate Cox regression to identify predictors of death.
Main Results:
- No significant difference in overall survival between ischemic and nonischemic cardiomyopathy groups (P=0.24).
- Ischemic cardiomyopathy patients had higher rates of gastrointestinal bleeding, particularly from arteriovenous malformations and ulcers (P=0.03).
- Older age, prior sternotomy, elevated bilirubin, and concomitant procedures predicted mortality, not the cause of heart failure.
Conclusions:
- While cardiomyopathy etiology does not impact overall survival with CF-LVADs, ischemic cardiomyopathy is linked to increased gastrointestinal bleeding risk.
- These findings highlight the need for targeted monitoring and management of GI complications in ischemic cardiomyopathy patients with CF-LVADs.
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