Left ventricular assist devices for treatment of refractory advanced heart failure: the Western Australian experience.
Intern Med J
; 54(3): 438-445, 2024 Mar.
Article
em En
| MEDLINE
| ID: mdl-37615052
ABSTRACT
BACKGROUND:
Left ventricular (LV) assist devices (LVADs) can prolong survival and improve quality of life in end-stage heart failure.AIMS:
Review outcomes of the Western Australian LVAD programme.METHODS:
Retrospective database and medical record review.RESULTS:
One hundred forty-seven LVADs have been implanted in 23 years, of which 95 were newer-generation devices (HeartWare HVAD [HW], HeartMate II and HeartMate 3). Presented data refer to these devices only. Most patients (94%) were classed as bridge-to-transplant or -candidacy/decision, with the remainder classed as 'destination therapy' (DT). Mean LV ejection fraction was 20%, and 36% had severe right ventricular dysfunction. Sixty-two percent of patients had a nonischaemic cardiomyopathy. Following LVAD implant, the median length of stay in intensive care was 2 days, and in the hospital overall was 23 days. Ninety-six percent of patients survived to hospital discharge, and, following discharge, 98% of days with LVAD were spent as an outpatient. The median number of hospital readmissions was 1.5 per patient per year. LVAD-associated infection requiring admission or intravenous antibiotics at any time after implant occurred in 36%, significant gastrointestinal bleeding in 19% and stroke in 11%. The percentage of patients alive with LVAD still in situ at 1, 2 and 5 years was 94%, 88% and 62% respectively, which exceeds current international registry outcomes. All DT patients survived at least 4 years, spending 97% of days with LVAD as an outpatient. The two longest-surviving HW DT patients worldwide (11.3 and 10.5 years) are among this cohort.CONCLUSIONS:
Excellent outcomes can be achieved with LVADs in appropriately selected patients.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Coração Auxiliar
/
Transplante de Coração
/
Insuficiência Cardíaca
Tipo de estudo:
Risk_factors_studies
Limite:
Humans
País/Região como assunto:
Oceania
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article