181: Early Neurological Adverse Events (NAE) after Pulsatile VAD Implantation in 455 Patients: Incidence, Severity and Outcome

Kormos, Robert L.; Kirklin, James K.; Naftel, David C.; Young, James B.; Acker, Matthew; Jessup, M.; Jeevanandam, Valluvan; Baldwin, T; Camacho, M.; Ascheim, Deborah D.

doi:10.1016/j.healun.2008.11.188

Cited by 6 publications

(1 citation statement)

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“…Despite this, several reports suggest that females exhibit higher mortality and complication rates after LVAD implantation. 5,[14][15][16][17][18] It appears that females are referred for MCS when they are usually sicker and have worse clinical features. 19 Less social support, poor economic status, higher self-refusal rates, and more religious and pessimistic attitudes are potential explanations for why females present for LVAD evaluation at a later stage of their disease.…”

Section: Discussionmentioning

confidence: 99%

Lessons Learned from 150 Continuous-Flow Left Ventricular Assist Devices

Tsiouris

Paone²,

Nemeh³

et al. 2015

ASAIO Journal

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Continuous-flow (CF) left ventricular assist devices (LVADs) have become the standard of care for patients with advanced heart failure refractory to optimal medical therapy. The goal of this study was to review our 7 year single institutional experience with CF LVADs. Mean age was 50.4 + 12.5 (17-69) years for bridge-to-transplantation (BTT) patients and 57.6 + 10.4 (31-81) years for destination therapy (DT) patients (p < 0.001). Overall, 38 patients (26%) were female and 58 (41%) were African American. Etiology of heart failure was ischemic in 54 patients (37%) and nonischemic in 93 patients (63%). Overall survival at 30 days, 6 months, 12 months, and 2 years was 93%, 89%, 84%, and 81%, respectively. Gastrointestinal bleeding (GIB) was the most common complication (24%), followed by stroke (18%), right ventricular (RV) failure (18%), ventilator-dependent respiratory failure (10%), reoperation for bleeding (10%), and driveline infection (9%). These data demonstrate excellent survival with low mortality for both BTT and DT patients on long-term LVAD support. However, for LVAD therapy to become the gold standard for long-term treatment of end-stage heart failure and a plausible alternative to heart transplantation, we need to continue to improve the incidence of frequent postoperative complications, such as RV failure, driveline infections, strokes, and GIB.

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