Sabashnikov, Anton ORCID: 0000-0002-6289-1035, Mohite, Prashant N., Zych, Bartlomiej, Garcia, Diana, Popov, Aron-Frederik ORCID: 0000-0003-4226-3004, Weymann, Alexander, Patil, Nikhil P., Hards, Rachel, Capoccia, Massimo ORCID: 0000-0002-2351-9994, Wahlers, Thorsten, De Robertis, Fabio, Bahrami, Toufan, Amrani, Mohamed, Banner, Nicholas R. and Simon, Andre R. (2014). Outcomes and Predictors of Early Mortality After Continuous-Flow Left Ventricular Assist Device Implantation as a Bridge to Transplantation. Asaio J., 60 (2). S. 162 - 170. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1538-943X

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Abstract

Left ventricular assist devices (LVADs) are fast becoming standard of care for patients with advanced heart failure. However, despite continuous improvement in VAD technology, there remains a significant early postoperative morbidity and mortality in this extreme patient group. The aim of the current study was to explore the short-term outcomes and predictors for 90 day mortality in the patients after implantation of continuous-flow LVAD. Perioperative clinical, echocardiographic, hemodynamic, and laboratory data of 90 day survivors and nonsurvivors were collected and compared retrospectively. Multivariate logistic regression analysis was performed on univariate predictors for 90 day mortality with an entry criterion of p < 0.1. Between July 2006 and May 2012, 117 patients underwent implantation of a continuous-flow LVAD as a bridge to transplantation: 71 (60.7%) HeartMate II (Thoratec Corp, Pleasanton, CA) and 46 (39.3%) HVAD (HeartWare International, Framingham, MA). All-cause 90 day mortality was 17.1%. Multivariate analysis revealed higher preoperative central venous pressure (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.014-1.378; p = 0.033) and higher age (OR, 1.14; 95% CI, 1.01-1.38; p = 0.045) as the only independent predictors for 90 day mortality. Optimization of preoperative volume status, preload, and right heart function as well as age-based selection of candidates for LVAD support are the critical factors influencing early outcome after continuous-flow LVAD implantation.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Sabashnikov, AntonUNSPECIFIEDorcid.org/0000-0002-6289-1035UNSPECIFIED
Mohite, Prashant N.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zych, BartlomiejUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Garcia, DianaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Popov, Aron-FrederikUNSPECIFIEDorcid.org/0000-0003-4226-3004UNSPECIFIED
Weymann, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Patil, Nikhil P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hards, RachelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Capoccia, MassimoUNSPECIFIEDorcid.org/0000-0002-2351-9994UNSPECIFIED
Wahlers, ThorstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
De Robertis, FabioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bahrami, ToufanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Amrani, MohamedUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Banner, Nicholas R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Simon, Andre R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-445110
DOI: 10.1097/MAT.0000000000000035
Journal or Publication Title: Asaio J.
Volume: 60
Number: 2
Page Range: S. 162 - 170
Date: 2014
Publisher: LIPPINCOTT WILLIAMS & WILKINS
Place of Publication: PHILADELPHIA
ISSN: 1538-943X
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
HEART-FAILURE; CLINICAL-EXPERIENCE; SYSTEM; RISK; CANDIDATES; SUPPORT; OLDERMultiple languages
Engineering, Biomedical; TransplantationMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/44511

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