RT Journal Article
SR Electronic
T1 Right Heart Failure in Different Left Ventricular Assist Devices: Single-Center Experience
JF Ochsner Journal
JO Ochsner J
FD O. P. Jindal Global University
SP 194
OP 198
DO 10.31486/toj.19.0025
VO 19
IS 3
A1 Aditya Bansal
A1 David Schexnayder
A1 Faisal Akhtar
A1 Arnav Bansal
A1 Cruz Velasco-Gonzalez
A1 Arjun Verma
A1 Michael Bates
A1 Patrick E. Parrino
A1 Sapna Desai
A1 Jay K. Bhama
YR 2019
UL http://www.ochsnerjournal.org/content/19/3/194.abstract
AB Background: Right heart failure (RHF) following left ventricular assist device (LVAD) implantation increases morbidity and mortality for those who develop this complication. The purpose of this study was to assess the differences in incidence of RHF and outcomes between 2 types of continuous-flow LVADs at a single center.Methods: From January 2012 through June 2016, 184 patients were implanted with a continuous-flow LVAD (161 patients with the HeartMate II and 23 patients with the HeartWare device) either as a bridge to transplant or as destination therapy. Preoperative demographics, medical history, laboratory values, hemodynamics, and device type were analyzed to determine the variables associated with RHF and mortality.Results: Preoperative variables between the 2 groups were homogeneous. Most patients were Interagency Registry for Mechanically Assisted Circulatory Support profile 1 or 2 (92%) and New York Heart Association class IV (81%). More patients in the HeartMate II group had the indication of destination therapy (54% vs 30%), while more patients in the HeartWare group were implanted as bridge to transplant (70% vs 46%). RHF occurred in 57% of HeartWare patients compared to 16% of patients who received the HeartMate II (P=0.0001). After propensity score analysis, patients receiving the HeartWare device had increased odds for RHF (P=0.0013) and renal failure requiring dialysis (P=0.0135). The HeartMate II patient survival rate exceeded the HeartWare patient survival rate at 1 year (82.1% vs 67.2%) and at 2 years (74.6% vs 61.7%), but this difference did not achieve statistical significance (log-rank P=0.087).Conclusion: These results indicate that device type may affect RHF incidence and mortality. Studies at other centers are needed to replicate these findings.