Septuagenarian population has similar survival and outcomes to younger patients after left ventricular assist device implantation.
Assistance cardiaque ventriculaire gauche
Complications de LVAD
Elderly patients
LVAD-related complications
Left ventricular assist device
Patients âgés
Septuagenarians
Septuagénaires
Survie
Survival
Journal
Archives of cardiovascular diseases
ISSN: 1875-2128
Titre abrégé: Arch Cardiovasc Dis
Pays: Netherlands
ID NLM: 101465655
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
received:
06
03
2020
revised:
20
03
2020
accepted:
12
05
2020
pubmed:
22
9
2020
medline:
16
12
2020
entrez:
21
9
2020
Statut:
ppublish
Résumé
Left ventricular assist device (LVAD) implantation may be an attractive alternative therapeutic option for elderly patients with heart failure who are ineligible for heart transplantation. We aimed to describe the characteristics and outcomes of elderly patients (i.e. aged≥70 years) receiving an LVAD. This observational study was conducted in 19 centres between 2006 and 2016. Patients were divided into two groups-younger (aged<70 years) and elderly (aged≥70 years), based on age at time of LVAD implantation. A total of 652 patients were included in the final analysis, and 74 patients (11.3%) were aged≥70 years at the time of LVAD implantation (maximal age 77.6 years). The proportion of elderly patients receiving an LVAD each year was constant, with a median of 10.6% (interquartile range 8.0-15.4%) per year, and all were implanted as destination therapy. Elderly and younger patients had similar durations of hospitalization in intensive care units and total lengths of hospital stays. Both age groups experienced similar rates of LVAD-related complications (i.e. stroke, bleeding, driveline infection and LVAD exchange), and the occurrence of LVAD complications did not impact survival in the elderly group compared with the younger group. Lastly, when compared with younger patients implanted as destination therapy, the elderly group also exhibited similar mid-term survival. This work strongly suggests that selected elderly adults can be scheduled for LVAD implantation.
Sections du résumé
BACKGROUND
BACKGROUND
Left ventricular assist device (LVAD) implantation may be an attractive alternative therapeutic option for elderly patients with heart failure who are ineligible for heart transplantation.
AIM
OBJECTIVE
We aimed to describe the characteristics and outcomes of elderly patients (i.e. aged≥70 years) receiving an LVAD.
METHODS
METHODS
This observational study was conducted in 19 centres between 2006 and 2016. Patients were divided into two groups-younger (aged<70 years) and elderly (aged≥70 years), based on age at time of LVAD implantation.
RESULTS
RESULTS
A total of 652 patients were included in the final analysis, and 74 patients (11.3%) were aged≥70 years at the time of LVAD implantation (maximal age 77.6 years). The proportion of elderly patients receiving an LVAD each year was constant, with a median of 10.6% (interquartile range 8.0-15.4%) per year, and all were implanted as destination therapy. Elderly and younger patients had similar durations of hospitalization in intensive care units and total lengths of hospital stays. Both age groups experienced similar rates of LVAD-related complications (i.e. stroke, bleeding, driveline infection and LVAD exchange), and the occurrence of LVAD complications did not impact survival in the elderly group compared with the younger group. Lastly, when compared with younger patients implanted as destination therapy, the elderly group also exhibited similar mid-term survival.
CONCLUSION
CONCLUSIONS
This work strongly suggests that selected elderly adults can be scheduled for LVAD implantation.
Identifiants
pubmed: 32952086
pii: S1875-2136(20)30183-2
doi: 10.1016/j.acvd.2020.05.018
pii:
doi:
Types de publication
Comparative Study
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
701-709Informations de copyright
Copyright © 2020 Elsevier Masson SAS. All rights reserved.