197LEFT VENTRICULAR ASSIST DEVICE VERSUS HEART TRANSPLANTATION IN PATIENTS OVER 60 YEARS: A SINGLE-CENTRE EXPERIENCE

• Published in: Interactive cardiovascular and thoracic surgery 2013-10, Vol.17 (suppl_2), p.S117-S117
• Main Authors: Botta, L., Cannata, A., Bruschi, G., Colombo, T., Russo, C.F., Paino, R., Ammirati, E., Frigerio, M., Martinelli, L.
• Format: Article
• Language: English
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1093/icvts/ivt372.197

Objectives: The shortage of donors for heart transplantation (HTx) and the limited availability of the left ventricular assist device (LVAD) due to its cost, influence the treatment choice in patients with advanced heart failure, particularly in the elderly. We compared outcomes of patients over 60 years undergoing LVAD or HTx in our Department. Methods: From 2006 to 2012, 42 patients over 60 years were transplanted (T group: 31 males [73.8%], mean age 62.5 years) and 19 patients (17 males, mean age 65.2 years) were supported with a long-term continuous flow LVAD (V group: 14 HeartMate II, 3 Incor, 1 DeBakey, 1 HeartWare). Preoperative details were comparable between groups. Results: In-hospital mortality did not differ significantly between the two groups (T group 26.2%, V group 35.2%, P = 0.44). Following hospital discharge, six-year survival was similar between the two groups (T group 72.2%, V group 68.5%, log-rank = 0.83). One patient required LVAD replacement three years after implant, while two out of 19 have been successfully transplanted 12 and 14 months after LVAD implantation. Conclusions: In our experience, the survival of patients over 60 years seems to be unaffected by the initial choice between LVAD and transplantation, albeit in-hospital mortality was higher following LVAD implantation. LVAD could be considered a practicable alternative to HTx in the elderly.