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Risk factor analysis of Swedish left ventricular assist device (LVAD) patients

Granfeldt, H; Koul, Bansi LU ; Wiklund, L; Peterzen, B; Lonn, U; Babic, A and Ahn, HC (2003) In Annals of Thoracic Surgery 76(6). p.1993-1998
Abstract
Background. The use of left ventricular assist devices (LVADs) is established as a bridge to heart transplantation. Methods. All Swedish patients on the waiting list for heart transplantation, treated with LVAD since 1993 were retrospectively collected into a database and analyzed in regards to risk factors for mortality and morbidity. Results. Fifty-nine patients (46 men) with a median age of 49 years (range, 14 to 69 years), Higgins score median of 9 (range, 3 to 15), EuroScore median of 10 (range, 5 to 17) were investigated. Dominating diagnoses were dilated cardiomyopathy in 61% (n = 36) and ischemic cardiomyopathy in 18.6% (n = 11). The patients were supported with LVAD for a median time of 99.5 days (range, I to 873 days). Forty-five... (More)
Background. The use of left ventricular assist devices (LVADs) is established as a bridge to heart transplantation. Methods. All Swedish patients on the waiting list for heart transplantation, treated with LVAD since 1993 were retrospectively collected into a database and analyzed in regards to risk factors for mortality and morbidity. Results. Fifty-nine patients (46 men) with a median age of 49 years (range, 14 to 69 years), Higgins score median of 9 (range, 3 to 15), EuroScore median of 10 (range, 5 to 17) were investigated. Dominating diagnoses were dilated cardiomyopathy in 61% (n = 36) and ischemic cardiomyopathy in 18.6% (n = 11). The patients were supported with LVAD for a median time of 99.5 days (range, I to 873 days). Forty-five (76%) patients received transplants, and 3 (5.1%) patients were weaned from the device. Eleven patients (18.6%) died during LVAD treatment. Risk factor analysis for mortality before heart transplantation showed significance for a high total amount of autologous blood transfusions (p < 0.001), days on mechanical ventilation postoperatively (p < 0.001), prolonged postoperative intensive care unit stay (p = 0.007), and high central venous pressure 24 hours postoperatively and at the final measurement (p = 0.03 and 0.01, respectively). Mortality with LVAD treatment was 18.6% (n = 11). High C-reactive protein (p = 0.001), low mean arterial pressure (p = 0.03), and high cardiac index (p = 0.03) preoperatively were risk factors for development of right ventricular failure during LVAD treatment. Conclusions. The Swedish experience with LVAD as a bridge to heart transplantation was retrospectively collected into a database. This included data from transplant and nontransplant centers. Figures of mortality and morbidity in the database were comparable to international experience. Specific risk factors were difficult to define retrospectively as a result of different protocols for follow-up among participating centers. (C) 2003 by The Society of Thoracic Surgeons. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of Thoracic Surgery
volume
76
issue
6
pages
1993 - 1998
publisher
Elsevier
external identifiers
  • wos:000186986500046
  • pmid:14667628
  • scopus:0345527904
ISSN
1552-6259
DOI
10.1016/S0003-4975(03)01016-6
language
English
LU publication?
yes
id
1b74333a-16ce-4f08-adff-c8f2a97e1913 (old id 293978)
alternative location
http://ats.ctsnetjournals.org/cgi/content/abstract/76/6/1993
date added to LUP
2007-09-03 11:52:53
date last changed
2018-10-03 11:02:43
@article{1b74333a-16ce-4f08-adff-c8f2a97e1913,
  abstract     = {Background. The use of left ventricular assist devices (LVADs) is established as a bridge to heart transplantation. Methods. All Swedish patients on the waiting list for heart transplantation, treated with LVAD since 1993 were retrospectively collected into a database and analyzed in regards to risk factors for mortality and morbidity. Results. Fifty-nine patients (46 men) with a median age of 49 years (range, 14 to 69 years), Higgins score median of 9 (range, 3 to 15), EuroScore median of 10 (range, 5 to 17) were investigated. Dominating diagnoses were dilated cardiomyopathy in 61% (n = 36) and ischemic cardiomyopathy in 18.6% (n = 11). The patients were supported with LVAD for a median time of 99.5 days (range, I to 873 days). Forty-five (76%) patients received transplants, and 3 (5.1%) patients were weaned from the device. Eleven patients (18.6%) died during LVAD treatment. Risk factor analysis for mortality before heart transplantation showed significance for a high total amount of autologous blood transfusions (p &lt; 0.001), days on mechanical ventilation postoperatively (p &lt; 0.001), prolonged postoperative intensive care unit stay (p = 0.007), and high central venous pressure 24 hours postoperatively and at the final measurement (p = 0.03 and 0.01, respectively). Mortality with LVAD treatment was 18.6% (n = 11). High C-reactive protein (p = 0.001), low mean arterial pressure (p = 0.03), and high cardiac index (p = 0.03) preoperatively were risk factors for development of right ventricular failure during LVAD treatment. Conclusions. The Swedish experience with LVAD as a bridge to heart transplantation was retrospectively collected into a database. This included data from transplant and nontransplant centers. Figures of mortality and morbidity in the database were comparable to international experience. Specific risk factors were difficult to define retrospectively as a result of different protocols for follow-up among participating centers. (C) 2003 by The Society of Thoracic Surgeons.},
  author       = {Granfeldt, H and Koul, Bansi and Wiklund, L and Peterzen, B and Lonn, U and Babic, A and Ahn, HC},
  issn         = {1552-6259},
  language     = {eng},
  number       = {6},
  pages        = {1993--1998},
  publisher    = {Elsevier},
  series       = {Annals of Thoracic Surgery},
  title        = {Risk factor analysis of Swedish left ventricular assist device (LVAD) patients},
  url          = {http://dx.doi.org/10.1016/S0003-4975(03)01016-6},
  volume       = {76},
  year         = {2003},
}