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Sex-based considerations for implementation of ventricular assist device therapy.
K Candis Jones-Ungerleider1, Angela Rose1, Kevin Knott1
1Department of Cardiac Surgery, School of Medicine, University of Michigan, Ann Arbor, MI, United States.
Frontiers in Cardiovascular Medicine
|November 4, 2022
Summary
Women receive advanced heart failure therapies like left ventricular assist device (LVAD) implantation less often than men. Research is needed to understand and address these disparities in advanced heart failure treatment.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Health Disparities
Background:
- Women with advanced heart failure are referred for surgical therapies, including durable left ventricular assist device (LVAD) implantation and heart transplantation, at significantly lower rates than men.
- Existing research primarily focuses on outcomes post-LVAD or heart transplantation, with limited understanding of pre-operative factors contributing to lower referral rates in women.
Purpose of the Study:
- To investigate the reasons behind the lower rates of advanced surgical therapy utilization in women with advanced heart failure compared to men.
- To identify pre-operative factors contributing to disparities in advanced heart failure treatment delivery for female patients.
Main Methods:
- This study reviews existing literature and clinical data on advanced heart failure treatment patterns.
- Analysis focuses on identifying pre-operative variables and outcome differences between male and female patients undergoing or considered for LVAD implantation and heart transplantation.
Main Results:
- Females exhibit higher mortality rates after LVAD implantation and increased risks of bleeding, clotting, and right ventricular failure compared to males.
- Pre-operative factors driving lower LVAD implant rates in women remain largely undefined in current literature.
Conclusions:
- Significant disparities exist in the delivery of advanced heart failure therapies between men and women.
- Further research is crucial to elucidate these disparities and improve equitable access to life-saving treatments for women and other underserved populations.
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