scholarly journals Long-term prognosis and cost-effectiveness of left ventricular assist device as bridge to transplantation: A systematic review

2017 ◽  
Vol 235 ◽  
pp. 22-32 ◽  
Author(s):  
Michael Seco ◽  
Dong Fang Zhao ◽  
Michael J. Byrom ◽  
Michael K. Wilson ◽  
Michael P. Vallely ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Left Ventricular Assist Device ◽  
Left Ventricular ◽  
Bridge To Transplantation ◽  
Assist Device ◽  
Ventricular Assist ◽  
Left Ventricular Assist ◽  
Long Term Prognosis

scholarly journals Long-Term Survival of Patients With Advanced Heart Failure Receiving an Left Ventricular Assist Device Intended as a Bridge to Transplantation

2020 ◽  
Vol 13 (3) ◽  
Author(s):  
Daniel Zimpfer ◽  
Arnt E. Fiane ◽  
Robert Larbalestier ◽  
Steven Tsui ◽  
Paul Jansz ◽  
...  
Keyword(s):  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Clinical Information ◽  
Left Ventricular ◽  
Bridge To Transplantation ◽  
Assist Device ◽  
Term Survival ◽  
Ventricular Assist ◽  
Left Ventricular Assist

Background: The paucity of available hearts for transplantation means that more patients remain on durable left ventricular support for longer periods of time. The Registry to Evaluate the HeartWare Left Ventricular Assist System was an investigator-initiated multicenter, prospective, single-arm database established to collect post-Conformité Européene mark clinical information on patients receiving the HeartWare ventricular assist device system as a bridge to transplantation. This registry represents the longest multicenter follow-up of primary left ventricular assist device outcomes. Methods: Data were collected on 254 commercial implants performed between February 2009 and March 2012 from 9 centers in Europe (7) and Australia (2). Patients were followed to device explant, heart transplantation, or death. The outcomes of patients through July/August 2018 were analyzed. Summary statistics were used to describe patient demographics, adverse events, length of support, and outcomes for this extended-term cohort. Results: A total of 122 patients were on support for >2 years, and 34 patients were on support for >5 years. Twenty nine patients are still alive on support (support ranging from 1213 to 3396 days), and 23 of those are on their original HeartWare ventricular assist device system. Kaplan–Meier survival through 7 years was 51%. Through 6 years, freedom from any stroke was 82%, while freedom from severely disabling stroke was 89%. Conclusions: Low rates of heart transplant now require longer periods of left ventricular assist device support in patients. This analysis demonstrates that long-term support using a HeartWare ventricular assist device system offers survival of 51% through 7 years.

It keeps on turning: Effects of prolonged long-term left ventricular assist device support as a bridge to heart transplantation

2018 ◽  
Vol 42 (2) ◽  
pp. 65-71
Author(s):  
Bastian Schmack ◽  
Leonie Grossekettler ◽  
Mohamed Zeriouh ◽  
Alexander Weymann ◽  
Prashant Mohite ◽  
...  
Keyword(s):  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Left Ventricular ◽  
Bridge To Transplantation ◽  
Assist Device ◽  
Ventricular Assist ◽  
Device Implantation ◽  
Left Ventricular Assist ◽  
Device Exchange

Objectives: Increasing incidence of end-stage heart failure has moved the therapy with left ventricular assist devices to the forefront of surgical treatment. Moreover, continuous sophistication in this technology has resulted in increasing proportion of patients on prolonged support. Early and late complications after left ventricular assist device as a bridge to transplantation and present factors associated with long-term support and long-term outcomes of patients supported for at least 1 year were compared. Methods: A total of 163 consecutive patients who underwent left ventricular assist device implantation as bridge to transplantation were included. A total of 79 patients were supported for at least 1 year (long-term support), whereas 84 patients were supported for less than 1 year (short-term group). Results: Factors associated with a successful long-term support were male gender (p < 0.001), cessation of smoking at least 6 months prior to surgery (p = 0.045), previous implantation of implantable cardioverter defibrillator (p = 0.001) and rapid postoperative extubation (p = 0.018). Regarding echocardiographic parameters, higher left ventricular mass (p = 0.013) and larger left ventricular–end systolic (p = 0.008) and diastolic (p = 0.005) diameters prior to left ventricular assist device implantation were associated with long-term support. Short-term group showed higher mortality and higher proportion of patients who underwent device exchange due to device failure, and left ventricular assist device explantation for myocardial recovery was less frequent in the long-term support (p < 0.001). In addition, patients from the long-term support had significantly higher incidence of higher-grade aortic regurgitation (p = 0.005). Conclusion: Prolonged left ventricular assist device support as bridge to transplantation is associated with lower mortality and lower incidence of device failure requiring device exchange. However, long-term support reduces the chance of device explantation for myocardial recovery and increases the incidence of higher-grade aortic regurgitation in the follow-up.

Ultrastructural observations of the aorta of calves implanted with a mechanical left ventricular assist device

1990 ◽  
Vol 48 (3) ◽  
pp. 834-835
Author(s):  
J P Cassella ◽  
V Salih ◽  
T R Graham
Keyword(s):  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Left Ventricular ◽  
Aortic Tissue ◽  
Assist Device ◽  
Ventricular Assist ◽  
Transmission Electron ◽  
Left Ventricular Assist ◽  
Preliminary Study

Left ventricular assist systems are being developed for eventual long term or permanent implantation as an alternative to heart transplantation in patients unsuitable for or denied the transplant option. Evaluation of the effects of these devices upon normal physiology is required. A preliminary study was conducted to evaluate the morphology of aortic tissue from calves implanted with a pneumatic Left Ventricular Assist device-LVAD. Two 3 month old heifer calves (calf 1 and calf 2) were electively explanted after 128 days and 47 days respectively. Descending thoracic aortic tissue from both animals was removed immediately post mortem and placed into karnovsky’s fixative. The tissue was subsequently processed for transmission electron microscopy (TEM). Some aortic tissue was fixed in neutral buffered formalin and processed for routine light microscopy.

scholarly journals Outcome of right ventricular assist device implantation following left ventricular assist device implantation: Systematic review and meta-analysis

Perfusion ◽  
2021 ◽  
pp. 026765912110248
Author(s):  
Gregory Reid ◽  
Constantin Mork ◽  
Brigita Gahl ◽  
Christian Appenzeller-Herzog ◽  
Ludwig K von Segesser ◽  
...  
Keyword(s):  
Systematic Review ◽  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Left Ventricular ◽  
Assist Device ◽  
Ventricular Assist ◽  
Device Implantation ◽  
Left Ventricular Assist ◽  
Right Ventricular Assist Device

Objectives: The main aim was a systematic evaluation of the current evidence on outcomes for patients undergoing right ventricular assist device (RVAD) implantation following left ventricular assist device (LVAD) implantation. Methods: This systematic review was registered on PROSPERO (CRD42019130131). Reports evaluating in-hospital as well as follow-up outcome in LVAD and LVAD/RVAD implantation were identified through Ovid Medline, Web of Science and EMBASE. The primary endpoint was mortality at the hospital stay and at follow-up. Pooled incidence of defined endpoints was calculated by using random effects models. Results: A total of 35 retrospective studies that included 3260 patients were analyzed. 30 days mortality was in favour of isolated LVAD implantation 6.74% (1.98–11.5%) versus 31.9% (19.78–44.02%) p = 0.001 in LVAD with temporary need for RVAD. During the hospital stay the incidence of major bleeding was 18.7% (18.2–19.4%) versus 40.0% (36.3–48.8%) and stroke rate was 5.6% (5.4–5.8%) versus 20.9% (16.8–28.3%) and was in favour of isolated LVAD implantation. Mortality reported at short-term as well at long-term was 19.66% (CI 15.73–23.59%) and 33.90% (CI 8.84–59.96%) in LVAD respectively versus 45.35% (CI 35.31–55.4%) p ⩽ 0.001 and 48.23% (CI 16.01–80.45%) p = 0.686 in LVAD/RVAD group respectively. Conclusion: Implantation of a temporary RVAD is allied with a worse outcome during the primary hospitalization and at follow-up. Compared to isolated LVAD support, biventricular mechanical circulatory support leads to an elevated mortality and higher incidence of adverse events such as bleeding and stroke.

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