Titre
Clinical outcomes of HeartMate 3 left ventricular assist device support with a Bridge to Transplant vs a Destination Therapy strategy: a single-centre retrospective cohort.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Kikoïne, J.
Auteure/Auteur
Nowacka, A.
Auteure/Auteur
Schukraft, S.
Auteure/Auteur
Abdurashidova, T.
Auteure/Auteur
Yerly, P.
Auteure/Auteur
Tozzi, P.
Auteure/Auteur
Ltaief, Z.
Auteure/Auteur
Rosner, L.
Auteure/Auteur
Hullin, R.
Auteure/Auteur
Kirsch, M.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1424-3997
Statut éditorial
Publié
Date de publication
2024-07-10
Volume
154
Première page
3529
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article ; Observational Study ; Comparative Study
Publication Status: epublish
Publication Status: epublish
Résumé
Real-world outcomes with the HeartMate 3 left ventricular assist device (LVAD) depending on whether it's a bridge to transplantation (BTT) or destination therapy (DT) are poorly studied. We aimed to compare the profile and clinical outcomes of patients supported with HeartMate 3 according to a BTT or a DT pre-implantation strategy.
All patients consecutively implanted with HeartMate 3 at our centre (University Hospital of Lausanne, Switzerland) in 2015-2022 were analysed in a retrospective observational study. Indications for HeartMate 3 implantation were advanced heart failure despite optimal medical treatment. Patients were treated with a vitamin K antagonist anticoagulant combined with antiplatelet therapy after HeartMate 3 implantation and were followed up monthly at our institution.
Among 71 patients implanted with HeartMate 3 between 2015 and 2022, 51 (71.8%) were implanted as a BTT and 20 (28.2%) as DT. Their median age was 58 (IQR: 52-69) years and 84% of patients were classified as INTERMACS profiles 2-4. The median follow-up duration was 18.3 (IQR: 7.5-33.9) months. Patients in the DT group were older than those in the BTT group (p <0.001) and had more chronic renal failure (p <0.001). They also had a lower 5-year survival rate (mean ± standard error: 87.3 ± 5.6% vs 49.4 ± 15.1%) and more adverse events such as renal dysfunction requiring temporary perioperative dialysis (p = 0.08) or bleeding (p = 0.06).
Although patients supported with HeartMate 3 have favourable survival, those with LVAD-DT have poorer outcomes. There is a need to better select patients eligible for LVAD-DT in order to limit the burden of adverse events and improve their prognosis.
All patients consecutively implanted with HeartMate 3 at our centre (University Hospital of Lausanne, Switzerland) in 2015-2022 were analysed in a retrospective observational study. Indications for HeartMate 3 implantation were advanced heart failure despite optimal medical treatment. Patients were treated with a vitamin K antagonist anticoagulant combined with antiplatelet therapy after HeartMate 3 implantation and were followed up monthly at our institution.
Among 71 patients implanted with HeartMate 3 between 2015 and 2022, 51 (71.8%) were implanted as a BTT and 20 (28.2%) as DT. Their median age was 58 (IQR: 52-69) years and 84% of patients were classified as INTERMACS profiles 2-4. The median follow-up duration was 18.3 (IQR: 7.5-33.9) months. Patients in the DT group were older than those in the BTT group (p <0.001) and had more chronic renal failure (p <0.001). They also had a lower 5-year survival rate (mean ± standard error: 87.3 ± 5.6% vs 49.4 ± 15.1%) and more adverse events such as renal dysfunction requiring temporary perioperative dialysis (p = 0.08) or bleeding (p = 0.06).
Although patients supported with HeartMate 3 have favourable survival, those with LVAD-DT have poorer outcomes. There is a need to better select patients eligible for LVAD-DT in order to limit the burden of adverse events and improve their prognosis.
PID Serval
serval:BIB_DE9B7174255E
PMID
Open Access
Oui
Date de création
2024-08-19T06:57:59.394Z
Date de création dans IRIS
2025-05-21T05:57:08Z
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Nom
39137373.pdf
Version du manuscrit
published
Licence
https://creativecommons.org/licenses/by/4.0
Taille
703.78 KB
Format
Adobe PDF
PID Serval
serval:BIB_DE9B7174255E.P001
URN
urn:nbn:ch:serval-BIB_DE9B7174255E8
Somme de contrôle
(MD5):c5f2ddd52cdbd67800e1e906f150b679