• Ann. Thorac. Surg. · Mar 2020

    Multicenter Study

    Gender Differences in Outcomes After Implantation of Left Ventricular Assist Devices.

    • Abdelrahman Ahmed, Oluwole Adegbala, Emmanuel Akintoye, Chakradhari Inampudi, Mustafa Ajam, Ahmed S Yassin, Emmanuel Olawusi, Mohamed Shokr, Paulino Alvarez, and Alexandros Briasoulis.
    • Division of Cardiology, Wayne State University/Detroit Medical Center, Detroit, Michigan.
    • Ann. Thorac. Surg. 2020 Mar 1; 109 (3): 780-786.

    BackgroundLeft ventricular assist device (LVAD) implantation has historically been underutilized in women compared with men. It was hypothesized that the introduction of continuous-flow LVADs would lead to more LVAD implantations in women and possibly narrow the gender gap.MethodsPatients who underwent LVAD implantation between 2009 and 2014 were identified using the national inpatient sample.ResultsA total of 3511 patients (17,251 when weighted) underwent LVAD implantation in the United States between 2009 and 2014. Mean age was 56 years and there were 817 women in the study sample (23.32%). LVAD implantations in women doubled from 2009 to 2014, but men continued to receive LVAD 3 times more than women. Inpatient mortality after LVAD placement was similar between men and women (13.42% women vs 12.85% men; odds ratio, 1.05; P = .16). Most common complications after LVAD implantation in both genders included acute kidney injury, bleeding requiring blood transfusion, and postoperative sepsis. There were no gender-specific differences in the incidence of periprocedural complications, including postoperative cardiac tamponade, postoperative thromboembolism, or sepsis. In addition, no significant difference was found in length of stay and median hospitalization cost. The use of extracorporeal membrane oxygenation did not differ between men and women. Subgroup analysis in patients older than 65 years of age showed higher in-hospital mortality but no differences between genders.ConclusionsThe number of women undergoing LVAD implantation has increased with the introduction of continuous-flow LVADs, but a gender gap still exists. Most major in-hospital outcomes after LVAD implantation are similar between genders.Copyright © 2020 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

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