Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese · 2024
Comparison of continuous flow centrifugal left ventricular assist devices as a bridge to transplant strategy in a low organ donation environment: single center experience.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Bonios Michael, Miliopoulos Dimitris, Gkouziouta Angeliki, Kogerakis Nektarios, Fragkoulis Sokratis, Armenis Iakovos, Zarkalis Dimitrios, Ieromonachos Konstantinos, Koliopoulou Antigoni, Leontiadis Evangelos, Georgiadou Panagiota, Vartela Vasiliki, Tsiapras Dimitrios, Sfirakis Petros, Kapelios Christos, Dimopoulos Stavros, Kaklamanis Loukas, Ntegiannis Dimitrios, Antoniou Theofani, Chamogeorgakis Themistokles, Adamopoulos Stamatis
Аннотация
OBJECTIVE: In patients with advanced heart failure, heart transplantation is currently the most effective treatment. However, in a low-organ donation environment, it is usually necessary to proceed in long-term mechanical circulatory support through left ventricular assist device (LVAD) implantation as bridge-to-transplantation.
METHODS: The study included all patients with advanced heart failure who underwent continuous flow LVAD implantation as a bridge to transplant strategy in our center (n = 68). Following LVAD implantation and for the period that patients were on LVAD support, pump thrombosis, strokes, gastrointestinal bleeding, and right heart failure occurrence rates were recorded. Outcomes were compared between patients implanted with HeartMate 3 (HM3) and HeartWare LVADs, as well as between patients who did reach heart transplantation (HTx group) and those who did not (noHTx group).
RESULTS: A total of 35 out of 68 patients underwent heart transplantation at a mean time of 691 ± 457 days; 41 received a HeartWare and 27 a HM3 device. HM3 patients had significantly better survival (p = 0.010) and lower complication rates (p = 0.025). In addition, the noHTx group had significantly higher complication rates compared with the HTx group (p = 0.00041). The 5-year estimated Kaplan-Meier survival rate following heart transplantation was 77%.
CONCLUSION: Patients with advanced heart failure gain substantial benefit from LVADs awaiting heart transplantation. In a low organ donation environment, the need for reliable LVADs can further improve the outcomes through the reduction of complications provided by current devices.
METHODS: The study included all patients with advanced heart failure who underwent continuous flow LVAD implantation as a bridge to transplant strategy in our center (n = 68). Following LVAD implantation and for the period that patients were on LVAD support, pump thrombosis, strokes, gastrointestinal bleeding, and right heart failure occurrence rates were recorded. Outcomes were compared between patients implanted with HeartMate 3 (HM3) and HeartWare LVADs, as well as between patients who did reach heart transplantation (HTx group) and those who did not (noHTx group).
RESULTS: A total of 35 out of 68 patients underwent heart transplantation at a mean time of 691 ± 457 days; 41 received a HeartWare and 27 a HM3 device. HM3 patients had significantly better survival (p = 0.010) and lower complication rates (p = 0.025). In addition, the noHTx group had significantly higher complication rates compared with the HTx group (p = 0.00041). The 5-year estimated Kaplan-Meier survival rate following heart transplantation was 77%.
CONCLUSION: Patients with advanced heart failure gain substantial benefit from LVADs awaiting heart transplantation. In a low organ donation environment, the need for reliable LVADs can further improve the outcomes through the reduction of complications provided by current devices.