A UK Single Centre Retrospective Analysis of the Relationship between Haemodynamic Changes and Outcome in Patients Undergoing Prolonged Left Ventricular Assist Device Support

Purpose: Despite their efficacy, LVADs remain associated with serious complications. The relationship between haemodynamic changes during support and outcome remains inadequately characterised. This association was investigated in LVAD recipients undergoing prolonged support.Methods: Forty patients...

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Bibliographic Details
Published in:Annals of Thoracic and Cardiovascular Surgery 2015, Vol.21(2), pp.151-156
Main Authors: Capoccia, Massimo, Bowles, Christopher T, Sabashnikov, Anton, Robertis, Fabio De, Amrani, Mohamed, Banner, Nicholas R, Simon, Andre
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
artificial heart
England
Female
heart failure
Heart Failure - diagnosis
Heart Failure - mortality
Heart Failure - physiopathology
Heart Failure - surgery
Heart-Assist Devices - adverse effects
Hemodynamics
Humans
Kaplan-Meier Estimate
LVAD
Male
Middle Aged
Original
Prosthesis Design
Pulmonary Artery - physiopathology
Pulmonary Circulation
Pulmonary Wedge Pressure
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
Vascular Resistance
Ventricular Function, Left
Young Adult
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Summary:Purpose: Despite their efficacy, LVADs remain associated with serious complications. The relationship between haemodynamic changes during support and outcome remains inadequately characterised. This association was investigated in LVAD recipients undergoing prolonged support.Methods: Forty patients receiving LVAD therapy for >2 years were reviewed retrospectively (mean support duration was 38.62 ± 15.28). Pre- and on-LVAD haemodynamic data were assessed in three groups: (1) those receiving ongoing support (n = 24); (2) those who underwent cardiac transplantation (n = 4); (3) those who died during support (n = 12).Results: For group 1 and 2, LVAD support achieved a decrease in mean PAP, mean PCWP, TPG, and PVR and an increase in thermodilution blood flow (TBF) with significance at ≤5% level. For group 3, there were non-significant changes in TPG and PVR at the 5% level but for mean PAP, mean PCWP, and TBF the changes were similar to Groups 1 and 2 with significance at ≤5% level. Aggregated data from all three groups showed a 58% increase in TBF on LVAD support.Conclusion: Highly significant and favourable haemodynamic changes were found. However, group 3 did not undergo decrease in TPG and PVR possibly because of suboptimal LVAD flow, right heart dysfunction and unavoidable prolongation of support.
ISSN:1341-1098
2186-1005
DOI:10.5761/atcs.oa.14-00075