Early and mid-term outcomes of left ventricular assist device implantation and future prospects View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-10

AUTHORS

Hiroki Hata, Tomoyuki Fujita, Yusuke Shimahara, Shunsuke Sato, Masanobu Yanase, Osamu Seguchi, Takuma Sato, Takeshi Nakatani, Junjiro Kobayashi

ABSTRACT

OBJECTIVES: Although implantable left ventricular assist device use as a bridge to heart transplantation is increasing, its permanent use as destination therapy is not permitted in Japan. This retrospective review assessed early and mid-term outcomes of implantable continuous-flow left ventricular assist device compared with extracorporeal pulsatile-flow left ventricular assist device implantation. Issues regarding left ventricular assist device as destination therapy are discussed. METHODS: From January 2009 to September 2013, 72 patients underwent left ventricular assist device implantation at our institute. Forty patients were supported by extracorporeal pulsatile-flow left ventricular assist devices (ex-VAD group) and 32 patients with implantable continuous-flow left ventricular assist devices (im-VAD group). RESULTS: The median duration of ventricular assist device support was 563 days. The actuarial survival rates at 1 and 3 years were 92.3 and 79.2 % in the ex-VAD group and 96.4 and 72.3 % in the im-VAD group, respectively. Approximately 50 % of patients in both groups developed cerebrovascular complications within 1 year postoperatively. Six months post-implantation, almost 90 % of the ex-VAD group patients suffered exit-site infection compared with about 50 % in the im-VAD group. Readmission rate was 1.74 per patient-year; major causes were driveline exit-site infection (52 %) and cerebrovascular complication (14 %). CONCLUSIONS: Early and mid-term outcomes were satisfactory after both extracorporeal pulsatile-flow left ventricular assist device and implantable continuous-flow left ventricular assist device implantation, although a considerable level of postoperative complications was observed. More data after left ventricular assist device surgery are needed to enable its consideration as a destination therapy option in Japan. More... »

PAGES

557-564

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11748-015-0538-7

DOI

http://dx.doi.org/10.1007/s11748-015-0538-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1047840744

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25802124


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40 schema:description OBJECTIVES: Although implantable left ventricular assist device use as a bridge to heart transplantation is increasing, its permanent use as destination therapy is not permitted in Japan. This retrospective review assessed early and mid-term outcomes of implantable continuous-flow left ventricular assist device compared with extracorporeal pulsatile-flow left ventricular assist device implantation. Issues regarding left ventricular assist device as destination therapy are discussed. METHODS: From January 2009 to September 2013, 72 patients underwent left ventricular assist device implantation at our institute. Forty patients were supported by extracorporeal pulsatile-flow left ventricular assist devices (ex-VAD group) and 32 patients with implantable continuous-flow left ventricular assist devices (im-VAD group). RESULTS: The median duration of ventricular assist device support was 563 days. The actuarial survival rates at 1 and 3 years were 92.3 and 79.2 % in the ex-VAD group and 96.4 and 72.3 % in the im-VAD group, respectively. Approximately 50 % of patients in both groups developed cerebrovascular complications within 1 year postoperatively. Six months post-implantation, almost 90 % of the ex-VAD group patients suffered exit-site infection compared with about 50 % in the im-VAD group. Readmission rate was 1.74 per patient-year; major causes were driveline exit-site infection (52 %) and cerebrovascular complication (14 %). CONCLUSIONS: Early and mid-term outcomes were satisfactory after both extracorporeal pulsatile-flow left ventricular assist device and implantable continuous-flow left ventricular assist device implantation, although a considerable level of postoperative complications was observed. More data after left ventricular assist device surgery are needed to enable its consideration as a destination therapy option in Japan.
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