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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
Safety and effectiveness after atrial shunt device in patients with heart failure:A systematic review and
Lihua Gao1, Zhenze Yu1, Pengfei Wang1
1Cardiac Department, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, PR China.
Background:
Limited data are available regarding the atrial shunt device (ASD), making it challenging to provide definitive recommendations for patients with heart failure (HF). We conducted a meta-regression analysis to identify individuals who may derive greater benefit from this device.
Methods:
We conducted a search across PubMed, EMBASE, and Cochrane databases, including 8 studies for meta-analysis. Estimated endpoints were derived using random-effects proportional meta-analysis. Additionally, meta-regression analysis was performed to elucidate the potential impact of key covariates on these endpoints.
Results:
A total of 522 patients were included. The pooled analysis revealed an estimated mortality rate of 1.9 % for patients who underwent ASD. Additionally, the proportion of patients who remained in NYHA III to IV was reduced to 22.5 %. Furthermore, there was an improvement of 35.1 meters in the 6-minute walk distance (6MWD) and a 16.2-point improvement in the KCCQ score. Meta-regression analysis indicated that NYHA III to IV status was found to be directly proportional to age (β= 2.799), hypertension (β= 0.782), diabetes (β= 0.951), and atrial fibrillation (β= 0.778). Hypertension and a high level of left ventricular ejection fraction (LVEF) were associated with less improvement in 6MWD and KCCQ score, whereas a higher NT-proBNP level was associated with better improvement in 6MWD and KCCQ score.
Conclusions:
ASD emerges as a safe choice for HF patients aiming to alleviate symptoms. Specifically, individuals with reduced EF or elevated NT-proBNP levels, and without concomitant hypertension, diabetes, or atrial fibrillation, appear to achieve more substantial symptom relief.
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