Impact of Ischaemic and Dilated Cardiomyopathy on Short-Term and Long-Term Survival After Ventricular Assist Device Implantation: A Single-Centre Experience.


Journal

Heart, lung & circulation
ISSN: 1444-2892
Titre abrégé: Heart Lung Circ
Pays: Australia
ID NLM: 100963739

Informations de publication

Date de publication:
Mar 2022
Historique:
received: 19 06 2021
revised: 21 08 2021
accepted: 26 08 2021
pubmed: 3 10 2021
medline: 22 2 2022
entrez: 2 10 2021
Statut: ppublish

Résumé

Prognosis of patients with end-stage heart failure is known to be impacted by the aetiology of heart failure (HF). Ischaemic cardiomyopathy (ICM) and dilated cardiomyopathy (DCM) are the most frequent pathologies necessitating ventricular assist device (VAD) support in these patients. However, the specific impact of ICM and DCM in clinical outcomes after VAD implantation remains unclear. Therefore, this study aimed to analyse clinical differences in ICM and DCM patients after LVAD surgery from the current institution. All consecutive patients from the LVAD centre were included in this retrospective study. To analyse specific differences in in-hospital outcomes, patients were divided into two groups: ICM and DCM. Long-term follow-up was calculated by Kaplan-Meier estimation of survival. Between January 2010 and July 2020, 60 consecutive patients underwent LVAD implantation at the institution: 36 patients (60%) were supported due to end-stage ICM and 24 patients (40%) in regard of therapy-refractory DCM. Baseline characteristics showed no between-group differences. The ICM patients showed a clear trend to higher amount of additional cardiac procedures during VAD surgery (36% ICM vs 12% DCM; p=0.052). In-hospital mortality was comparable between ICM and DCM patients (36% ICM vs 21% DCM; p=0.206). A trend towards higher frequency of pump thrombosis was seen in DCM patients (p=0.080). Long-term survival was comparable between the groups. The aetiology of heart failure did not impact short-term or long-term clinical outcomes after VAD surgery. Multicentre registry data are necessary to substantiate these findings.

Sections du résumé

BACKGROUND BACKGROUND
Prognosis of patients with end-stage heart failure is known to be impacted by the aetiology of heart failure (HF). Ischaemic cardiomyopathy (ICM) and dilated cardiomyopathy (DCM) are the most frequent pathologies necessitating ventricular assist device (VAD) support in these patients. However, the specific impact of ICM and DCM in clinical outcomes after VAD implantation remains unclear. Therefore, this study aimed to analyse clinical differences in ICM and DCM patients after LVAD surgery from the current institution.
METHODS METHODS
All consecutive patients from the LVAD centre were included in this retrospective study. To analyse specific differences in in-hospital outcomes, patients were divided into two groups: ICM and DCM. Long-term follow-up was calculated by Kaplan-Meier estimation of survival.
RESULTS RESULTS
Between January 2010 and July 2020, 60 consecutive patients underwent LVAD implantation at the institution: 36 patients (60%) were supported due to end-stage ICM and 24 patients (40%) in regard of therapy-refractory DCM. Baseline characteristics showed no between-group differences. The ICM patients showed a clear trend to higher amount of additional cardiac procedures during VAD surgery (36% ICM vs 12% DCM; p=0.052). In-hospital mortality was comparable between ICM and DCM patients (36% ICM vs 21% DCM; p=0.206). A trend towards higher frequency of pump thrombosis was seen in DCM patients (p=0.080). Long-term survival was comparable between the groups.
CONCLUSION CONCLUSIONS
The aetiology of heart failure did not impact short-term or long-term clinical outcomes after VAD surgery. Multicentre registry data are necessary to substantiate these findings.

Identifiants

pubmed: 34598889
pii: S1443-9506(21)01232-4
doi: 10.1016/j.hlc.2021.08.017
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

383-389

Informations de copyright

Copyright © 2021 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Auteurs

Borko Ivanov (B)

University Hospital Cologne, Heart Center Cologne, Department of Cardiothoracic Surgery, Cologne, Germany. Electronic address: borko.ivanov@uk-koeln.de.

Ilija Djordjevic (I)

University Hospital Cologne, Heart Center Cologne, Department of Cardiothoracic Surgery, Cologne, Germany.

Anton Sabashnikov (A)

University Hospital Cologne, Heart Center Cologne, Department of Cardiothoracic Surgery, Cologne, Germany.

Dirk Sindhu (D)

University Hospital Cologne, Heart Center Cologne, Department of Cardiothoracic Surgery, Cologne, Germany.

Stephan Hink (S)

University Hospital Cologne, Heart Center Cologne, Department of Cardiothoracic Surgery, Cologne, Germany.

Kaveh Eghbalzadeh (K)

University Hospital Cologne, Heart Center Cologne, Department of Cardiothoracic Surgery, Cologne, Germany.

Stephen Gerfer (S)

University Hospital Cologne, Heart Center Cologne, Department of Cardiothoracic Surgery, Cologne, Germany.

Christopher Gaisendrees (C)

University Hospital Cologne, Heart Center Cologne, Department of Cardiothoracic Surgery, Cologne, Germany.

Georg Schlachtenberger (G)

University Hospital Cologne, Heart Center Cologne, Department of Cardiothoracic Surgery, Cologne, Germany.

Christian Rustenbach (C)

University Hospital Cologne, Heart Center Cologne, Department of Cardiothoracic Surgery, Cologne, Germany.

Katharina Seuthe (K)

University Hospital Cologne, Heart Center Cologne, Department of Cardiology, Cologne, Germany.

Kuhn Regnier (K)

University Hospital Cologne, Heart Center Cologne, Department of Cardiothoracic Surgery, Cologne, Germany.

Navid Mader (N)

University Hospital Cologne, Heart Center Cologne, Department of Cardiothoracic Surgery, Cologne, Germany.

Roman Pfister (R)

University Hospital Cologne, Heart Center Cologne, Department of Cardiology, Cologne, Germany.

Mohamed Zeriouh (M)

Department of Cardiac Surgery, Campus Kerckhoff, University of Giessen, Bad Nauheim, Germany.

Parwis Rahmanian (P)

University Hospital Cologne, Heart Center Cologne, Department of Cardiothoracic Surgery, Cologne, Germany.

Thorsten Wahlers (T)

University Hospital Cologne, Heart Center Cologne, Department of Cardiothoracic Surgery, Cologne, Germany.

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