Outcome of patients receiving a continuous flow left ventricular assist device – a retrospective single center study

Figures & data

Table 1. Baseline characteristics of patients receiving a CF LVAD.

Characteristics	LVAD patients, n = 80
Age (years)	53 ± 12 (17–69)
Distribution
17–39	12 (15)
40–59	42 (53)
60–69	26 (33)
Male gender	68 (85)
BMI (kg/m2)	25.6 (17.0–37.2)
Diagnosis
Ischemic	32 (40)
Dilatated	38 (48)
Inflammatory	3 (4)
Other	7 (9)
LVEF (%)	18 ± 7 (9–40)
NYHA
Class III	13 (16)
Class IV	67 (84)
Intermacs
1	1 (1)
2	23 (29)
3	39 (49)
4	13 (16)
5	3 (4)
6	0 (0)
7	1 (1)
6MWT (m)	136 ± 184 (0–570)
Arrhythmia	28 (35)
Frequent flyer	13 (16)
Previous stroke	10 (13)
Preoperative situation
At home	21 (26)
Hospitalized	27 (34)
ICU	32 (40)
Renal replacement therapy	5 (6)
Mechanical ventilation	27 (34)
Preoperative mechanical circulatory support
ECMO	24 (30)
IABP	3 (4)
Both	2 (3)
Prior cardiac surgery
<30 days	5 (6)
>30 days	9 (11)
Strategy
Bridge to transplant/
decision	70 (88)
Destination therapy	9 (11)
Rescue	1 (1)

Continuous values presented as mean ± SD (range), categorical as n (%).

CF LVAD: continuous flow left ventricular assist device; BMI: body mass index; LVEF: left ventricle ejection fraction: NYHA: New York Heart Association functional class: 6MWT: 6-minute walk test: ICU: intensive care unit: ECMO: extracorporeal membrane oxygenation: IABP: intra-aortic balloon pump.

Table 2. Postoperative course after CF LVAD implantation.

Mechanical ventilation (days)	3.4 ± 6.9 (1–49)
Intravenous inotrope therapy (days)	6.8 ± 4.2 (1–20)
Early complications (within 48 h)
Bleeding requiring surgery	9 (11)
Aortic dissection	2 (3)
Death	1 (1)
Renal replacement therapy	16 (20)
Temporary RVAD	2 (3)
ICU stay (days)	10.8 ± 9.1 (1–52)
Hospital stay (days)	34.3 ± 17.9 (10–103)
Discharge
Home	73 (91)
Another hospital	1 (1)
In-hospital death	6 (8)

Continuous values presented ad mean ± SD (range), categorical as n (%).

CF LAVS: continuous flow left ventricular assist device; RVAD: right ventricular assist device; ICU: intensive care unit.

Figure 1. Kaplan–Meier analysis for overall survival in all 80 CF LVAD patients.

Figure 2. Kaplan–Meier survival analysis for age (a), diagnosis (b) and strategy (c). Differences between groups were insignificant with Log-Rank tests. BTT/BTDl: bridge do transplantation/decision; DT: destination therapy.

Table 3. Outcomes and causes of death after CF LVAD implantation.

Total follow-up time (days)	752 ± 654 (1–2618)
Time on pump (days)	529 ± 467 (1–2254)
Time to transplant (days)	663 ± 463 (143–2247)
Time to death (days)	398 ± 436 (1–1470)
Cause of death	18 (23)
MOF	4 (5)
Right heart failure	3 (4)
Stroke	3 (4)
ARDS	2 (3)
Sepsis	2 (3)
Pump thrombosis	1 (1)
Other	3 (4)

Continuous values presented as mean ± SD (range), categorical as n (%).

CF LVAD: continuous flow left ventricular assist device; MOF: multi-organ failure; ARDS: acute respiratory distress syndrome.

Table 4. Adverse events after CF LVAD implantation.

Severe right heart failure	15 (19)
Temporary RVAD requirement	2 (3)
Inotropic support	13 (16)
Neurological dysfunction	14 (18)
Non-disabling stroke	6 (8)
Fatal stroke	3 (4)
Transient ischemic attack	4 (5)
ICH	2 (3)
Neurological events	17
Peripheral thromboembolism	1 (1)
Suspected pump thrombosis	3 (4)
Major infection	21 (26)
Driveline	7 (9)
Pump/pocket	1 (1)
Sepsis	8 (10)
Device-related sepsis	3 (4)
Other	8 (10)
Infection events	34
Respiratory failure	15 (19)
Major bleeding	16 (20)
Gastrointestinal	11 (14)
Mediastinal	5 (6)
Pleural	1 (1)
Bleeding events	32

Values presented as n (%).

CF LVAD: continuous flow left ventricular assist device; RVAD: right ventricular assist device; ICH: intracerebral hemorrhage.

Figure 3. Kaplan–Meier analysis of freedom of gastrointestinal bleeding (a), driveline infection (b) and composite of death, major stroke or pump exchange (c).