Management of end-stage heart failure patients with or without ventricular assist device: an observational comparison of clinical and economic outcomes

• Published in: European journal of cardio-thoracic surgery 2018-01, Vol.53 (1), p.170-177
• Main Authors: Aissaoui, Nadia, Morshuis, Michiel, Maoulida, Hassani, Salem, Joe-Elie, Lebreton, Guillaume, Brunn, Matthias, Chatellier, Gilles, Hagège, Albert, Schoenbrodt, Michael, Puymirat, Etienne, Latremouille, Christian, Varnous, Shaida, Ouldamar, Salima, Guillemain, Romain, Diebold, Benoit, Guedeney, Paul, Barreira, Marc, Mutuon, Pierre, Guerot, Emmanuel, Paluszkiewicz, Lech, Hakim-Meibodi, Kavous, Schulz, Uwe, Danchin, Nicolas, Gummert, Jan, Durand-Zaleski, Isabelle, Leprince, Pascal, Fagon, Jean-Yves
• Format: Article
• Language: English
• Subjects: Life Sciences
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1093/ejcts/ezx258

Heart transplantation (HT) and ventricular assist devices (VAD) for the management of end-stage heart failure have not been directly compared. We compare the outcomes and use of resources with these 2 strategies in 2 European countries with different allocation systems. We studied 83 patients managed by VAD as the first option in Bad Oeynhausen, Germany (Group I) and 141 managed with either HT or medical therapy, as the first option, in Paris, France (Group II). The primary end-point was 2-year survival. Kaplan-Meier analyses were performed after the application of propensity score weights to mitigate the effects of non-random group assignment. The secondary end-points were resource utilization and costs. Subgroup analyses were performed for patients undergoing HT and patients treated with inotropes at the enrolment time. The Group I patients were more severely ill and haemodynamically compromised, and 28% subsequently underwent HT vs 55% primary HT in Group II, P