Preoperative Predictors of Mortality in Short-Term Continuous-Flow Ventricular Assist Devices. Issue 8 (November 2019)

• Record Type: Journal Article
• Authors: Bozso, Sabin J.; Buchholz, Holger; Pidborochynski, Tara; Freed, Darren H.; MacArthur, Roderick G. G.; Conway, Jennifer
• Is Part Of: ASAIO journal. Volume 65:Issue 8(2019)
• Publication Date: 2019-11
• Subjects: mechanical circulatory support -- risk factors -- outcomes; Artificial organs -- Periodicals; 617
• DOI: 10.1097/MAT.0000000000000902
• Languages: English
• ISSNs: 1058-2916

Abstract

Abstract : Short-term continuous-flow ventricular assist devices (STCF-VADs) are increasingly being utilized to support critically ill patients, despite limited information regarding overall outcomes. All adult patients supported with an STCF-VAD between June 2009 and December 2015 were included in this retrospective single-center study. Associations between preoperative characteristics and unsuccessful bridge (death on device or within 30 days postdecannulation) were assessed using logistic regression. A total of 61 patients (77% male) were identified with a median age at implant of 54.6 years. Left VADs were implanted in 51%, right VADs in 21%, and both VADs in 28%, and patients were supported for a median of 11 days. Overall, 23% were weaned to recovery, 13% underwent heart transplantation, 16% converted to long-term VADs, and 48% had an unsuccessful bridge. In multivariable analysis, only renal insufficiency or dialysis (odds ratio = 7.53; p = 0.002) remained a significant independent predictor of an unsuccessful bridge. Short-term continuous-flow VADs can successfully bridge adult patients with mortality around 50%. Preimplant renal insufficiency or dialysis is correlated with an unsuccessful bridge in our patient population, likely reflecting the severity of illness preimplant. Further studies are required to determine whether this factor remains significant in a larger patient population.