Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Continuous-flow LVADs in the Nordic countries : complications and mortality and its predictors

Braun, Oscar Ö. LU ; Nilsson, Johan LU orcid ; Gustafsson, Finn ; Dellgren, Göran ; Fiane, Arnt E. ; Lemström, Karl ; Hubbert, Laila ; Hellgren, Laila and Lund, Lars H. (2019) In Scandinavian Cardiovascular Journal 53(1). p.14-20
Abstract

Objectives: The purpose of this study was to assess complications and mortality and its predictors, with continuous-flow left ventricular assist devices (CF-LVADs) in the Nordic Countries. Design: This was a retrospective, international, multicenter cohort study. Results: Between 1993 and 2013, 442 surgically implanted long-term mechanical assist devices were used among 8 centers in the Nordic countries. Of those, 238 were CF-LVADs (HVAD or HeartMate II) implanted in patients >18 years with complete data. Postoperative complications and survival were compared and Cox proportion hazard regression analysis was used to identify predictors of mortality. The overall Kaplan–Meier survival rate was 75% at 1 year, 69% at 2 years and 63% at 3... (More)

Objectives: The purpose of this study was to assess complications and mortality and its predictors, with continuous-flow left ventricular assist devices (CF-LVADs) in the Nordic Countries. Design: This was a retrospective, international, multicenter cohort study. Results: Between 1993 and 2013, 442 surgically implanted long-term mechanical assist devices were used among 8 centers in the Nordic countries. Of those, 238 were CF-LVADs (HVAD or HeartMate II) implanted in patients >18 years with complete data. Postoperative complications and survival were compared and Cox proportion hazard regression analysis was used to identify predictors of mortality. The overall Kaplan–Meier survival rate was 75% at 1 year, 69% at 2 years and 63% at 3 years. A planned strategy of destination therapy had poorer survival compared to a strategy of bridge to transplantation or decision (2-year survival of 41% vs. 76%, p <.001). The most common complications were non-driveline infections (excluding sepsis) (44%), driveline infection (27%), need for continuous renal replacement therapy (25%) and right heart failure (24%). In a multivariate model age and left ventricular diastolic dimension was left as independent risk factors for mortality with a hazard ratio of 1.35 (95% confidence interval (CI) [1.01–1.80], p =.046) per 10 years and 0.88 (95% CI [0.72–0.99], p =.044) per 5 mm, respectively. Conclusion: Outcome with CF LVAD in the Nordic countries was comparable to other cohorts. Higher age and destination therapy require particularly stringent selection.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Heart failure, left ventricular assist device, mechanical circulatory support, outcomes
in
Scandinavian Cardiovascular Journal
volume
53
issue
1
pages
14 - 20
publisher
Taylor & Francis
external identifiers
  • scopus:85062496106
  • pmid:30776923
ISSN
1401-7431
DOI
10.1080/14017431.2019.1583365
language
English
LU publication?
yes
id
320e6f13-5388-44f9-9389-1de16d7ad16d
date added to LUP
2019-03-18 14:42:06
date last changed
2024-05-28 05:56:13
@article{320e6f13-5388-44f9-9389-1de16d7ad16d,
  abstract     = {{<p>Objectives: The purpose of this study was to assess complications and mortality and its predictors, with continuous-flow left ventricular assist devices (CF-LVADs) in the Nordic Countries. Design: This was a retrospective, international, multicenter cohort study. Results: Between 1993 and 2013, 442 surgically implanted long-term mechanical assist devices were used among 8 centers in the Nordic countries. Of those, 238 were CF-LVADs (HVAD or HeartMate II) implanted in patients &gt;18 years with complete data. Postoperative complications and survival were compared and Cox proportion hazard regression analysis was used to identify predictors of mortality. The overall Kaplan–Meier survival rate was 75% at 1 year, 69% at 2 years and 63% at 3 years. A planned strategy of destination therapy had poorer survival compared to a strategy of bridge to transplantation or decision (2-year survival of 41% vs. 76%, p &lt;.001). The most common complications were non-driveline infections (excluding sepsis) (44%), driveline infection (27%), need for continuous renal replacement therapy (25%) and right heart failure (24%). In a multivariate model age and left ventricular diastolic dimension was left as independent risk factors for mortality with a hazard ratio of 1.35 (95% confidence interval (CI) [1.01–1.80], p =.046) per 10 years and 0.88 (95% CI [0.72–0.99], p =.044) per 5 mm, respectively. Conclusion: Outcome with CF LVAD in the Nordic countries was comparable to other cohorts. Higher age and destination therapy require particularly stringent selection.</p>}},
  author       = {{Braun, Oscar Ö. and Nilsson, Johan and Gustafsson, Finn and Dellgren, Göran and Fiane, Arnt E. and Lemström, Karl and Hubbert, Laila and Hellgren, Laila and Lund, Lars H.}},
  issn         = {{1401-7431}},
  keywords     = {{Heart failure; left ventricular assist device; mechanical circulatory support; outcomes}},
  language     = {{eng}},
  month        = {{03}},
  number       = {{1}},
  pages        = {{14--20}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Cardiovascular Journal}},
  title        = {{Continuous-flow LVADs in the Nordic countries : complications and mortality and its predictors}},
  url          = {{http://dx.doi.org/10.1080/14017431.2019.1583365}},
  doi          = {{10.1080/14017431.2019.1583365}},
  volume       = {{53}},
  year         = {{2019}},
}