• Pol. Arch. Med. Wewn. · Aug 2020

    Short and long-term outcomes of continuous-flow left ventricular assist device therapy in 79 patients with end-stage heart failure.

    • Agnieszka Biełka, Mariusz Kalinowski, Jerzy Pacholewicz, Justyna Małyszek-Tumidajewicz, Jacek Waszak, Izabela Copik, Anetta Kowalczuk-Wieteska, Michał Zakliczyński, Piotr Przybyłowski, Marian Zembala, and Michał O Zembala.
    • Department of Cardiac, Vascular and Endovascular Surgery and Transplantology in Zabrze, Silesian Centre for Heart Diseases, Medical University of Silesia in Katowice, Zabrze, Poland. abielka@gmail.com
    • Pol. Arch. Med. Wewn. 2020 Aug 27; 130 (7-8): 589-597.

    IntroductionAn increasing number of patients with end‑stage heart failure, along with a shortage of heart donors, necessitates the use of mechanical circulatory support.ObjectivesThis single‑center retrospective study evaluated short- and long term outcomes of continuous‑flow left ventricular assist device (CF LVAD) therapy in patients with end stage heart failure.Patients And MethodsWe collected and assessed data of 79 patients (77 men, 2 women; mean age, 50.3 years; mean INTERMACS profile, 3.1) implanted with a CF‑LVAD between 2009 and 2017 (HeartMate 3 in 19 patients [24%]; HeartMate 2 in 9 [11.4%]; and HeartWare in 51 [64.6%]).ResultsThe mean time on CF-LVAD support was 604 days (range, 1–1758 days). There were 2 device exchanges due to pump thrombosis and 1 explantation due to heart regeneration; 9 patients (11.4%) underwent heart transplant. Stroke (nondisabling, 48%) occurred in 27.8% of patients (ischemic in 9 patients; hemorrhagic, in 14; both types, in 1) despite the standardized anticoagulation regimen. Major gastrointestinal bleeding and pump thrombosis were reported in 13 patients (16.5%), while 18 patients (22.8%) developed driveline infections (recurrent in 15 patients [19%]). Hemorrhagic stroke and bacteremia had a negative impact on survival. Hemorrhagic stroke was the main cause of death. Survival probability was 0.9 at 1 month and 0.81, 0.71, 0.61, and 0.53 at 1, 2, 3, and 4 years, respectively.ConclusionsAlthough CF‑LVAD support is associated with substantial adverse events, they do not significantly affect mortality (except hemorrhagic stroke and bacteremia). Novel devices seem to overcome these limitations, but larger studies are needed to support these findings.

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