Clinical Outcomes and Quality of Life With an Ambulatory Counterpulsation Pump in Advanced Heart Failure Patients: Results of the Multicenter Feasibility Trial.


Journal

Circulation. Heart failure
ISSN: 1941-3297
Titre abrégé: Circ Heart Fail
Pays: United States
ID NLM: 101479941

Informations de publication

Date de publication:
04 2020
Historique:
entrez: 9 4 2020
pubmed: 9 4 2020
medline: 18 8 2020
Statut: ppublish

Résumé

The NuPulseCV intravascular ventricular assist system (iVAS) provides extended duration ambulatory counterpulsation via a durable pump placed through the distal subclavian artery. We performed a prospective, single-arm, multicenter, US Food and Drug Administration-approved feasibility trial of iVAS therapy as a bridge to transplant or decision following the FIH (First-In-Human) trial. Forty-seven patients were enrolled, and 45 patients (median 61 years old, 37 males, and 30 listed on United Network of Organ Sharing) received iVAS support for median 44 (25-87) days. There were no intraoperative complications. Success was defined as survival or transplant on iVAS therapy free from disabling stroke. Outcome success at 30 days (the primary end point of this study) and at 6 months was 89% and 80%, respectively. During 6 months of iVAS support, 2 patients died and 2 patients experienced disabling neurological dysfunction. Six-minute walk distance, 2-minute step test, and Kansas City Cardiomyopathy Questionnaire score improved during 4-week iVAS support. This feasibility trial demonstrated promising short-term outcomes of iVAS therapy with improved functional capacity and quality of life during the therapy. Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02645539.

Sections du résumé

BACKGROUND
The NuPulseCV intravascular ventricular assist system (iVAS) provides extended duration ambulatory counterpulsation via a durable pump placed through the distal subclavian artery.
METHODS
We performed a prospective, single-arm, multicenter, US Food and Drug Administration-approved feasibility trial of iVAS therapy as a bridge to transplant or decision following the FIH (First-In-Human) trial.
RESULTS
Forty-seven patients were enrolled, and 45 patients (median 61 years old, 37 males, and 30 listed on United Network of Organ Sharing) received iVAS support for median 44 (25-87) days. There were no intraoperative complications. Success was defined as survival or transplant on iVAS therapy free from disabling stroke. Outcome success at 30 days (the primary end point of this study) and at 6 months was 89% and 80%, respectively. During 6 months of iVAS support, 2 patients died and 2 patients experienced disabling neurological dysfunction. Six-minute walk distance, 2-minute step test, and Kansas City Cardiomyopathy Questionnaire score improved during 4-week iVAS support.
CONCLUSIONS
This feasibility trial demonstrated promising short-term outcomes of iVAS therapy with improved functional capacity and quality of life during the therapy. Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02645539.

Identifiants

pubmed: 32264715
doi: 10.1161/CIRCHEARTFAILURE.119.006666
doi:

Banques de données

ClinicalTrials.gov
['NCT02645539']

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e006666

Auteurs

Nir Uriel (N)

Division of Cardiology, Columbia University Medical Center, New York, NY (N.U., G.S.).

Valluvan Jeevanandam (V)

Department of Surgery, University of Chicago Medical Center, IL (V.J., T.I., D.O., T.S., T.O., C.J., P.C., T.L.).

Teruhiko Imamura (T)

Department of Surgery, University of Chicago Medical Center, IL (V.J., T.I., D.O., T.S., T.O., C.J., P.C., T.L.).
Second Department of Medicine, University of Toyama, Japan (T.I.).

David Onsager (D)

Department of Surgery, University of Chicago Medical Center, IL (V.J., T.I., D.O., T.S., T.O., C.J., P.C., T.L.).

Tae Song (T)

Department of Surgery, University of Chicago Medical Center, IL (V.J., T.I., D.O., T.S., T.O., C.J., P.C., T.L.).

Takeyoshi Ota (T)

Department of Surgery, University of Chicago Medical Center, IL (V.J., T.I., D.O., T.S., T.O., C.J., P.C., T.L.).

Colleen Juricek (C)

Department of Surgery, University of Chicago Medical Center, IL (V.J., T.I., D.O., T.S., T.O., C.J., P.C., T.L.).

Pamela Combs (P)

Department of Surgery, University of Chicago Medical Center, IL (V.J., T.I., D.O., T.S., T.O., C.J., P.C., T.L.).

Thomas Lammy (T)

Department of Surgery, University of Chicago Medical Center, IL (V.J., T.I., D.O., T.S., T.O., C.J., P.C., T.L.).

Sonna Patel-Raman (S)

NuPulseCV, Raleigh, NC (S.P.-R., J.R.W.).

Joshua R Woolley (JR)

NuPulseCV, Raleigh, NC (S.P.-R., J.R.W.).

Gabriel Sayer (G)

Division of Cardiology, Columbia University Medical Center, New York, NY (N.U., G.S.).

Carmelo Milano (C)

Department of Cardiac Surgery, Duke University, Durham, NC (C.M., J.S.).

Jacob Schroder (J)

Department of Cardiac Surgery, Duke University, Durham, NC (C.M., J.S.).

Ezequiel Molina (E)

Department of Surgery, MedStar Washington Hospital Center, DC. (E.M.).

Jonathan Grinstein (J)

Department of Cardiology, MedStar Washington Hospital Center, DC. (J.G.).

Erik Suarez (E)

Department of Cardiovascular Surgery, Houston Methodist Research Institute, Houston, TX (E.S.).

Jerry D Estep (JD)

Kaufman Center for Heart Failure Treatment and Recovery, Cleveland Clinic Foundation, OH (J.D.E.).

Sanjeev Aggarwal (S)

Mid America Heart & Lung Surgeons, Saint Luke's Mid-America Heart Institute, Kansas City, MO (S.A.).

Scott Silvestry (S)

Department of Heart Failure and Transplant, AdventHealth Cardiovascular Institute, Orlando, FL (S.S., N.R.).

Nirav Raval (N)

Department of Heart Failure and Transplant, AdventHealth Cardiovascular Institute, Orlando, FL (S.S., N.R.).

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