Durability of left ventricular assist devices: Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) 2006 to 2011

Holman, William L.; Naftel, David C.; Eckert, Chad E.; Kormos, Robert L.; Goldstein, Daniel J.; Kirklin, James K.

doi:10.1016/j.jtcvs.2013.02.018

Cited by 66 publications

(34 citation statements)

References 16 publications

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“…In this context, the advent of implantable left ventricular assist device (LVAD) 51 represents a major medical progress for end-stage heart failure in selected patients [7,8], and 52 is currently used as a bridge-to-heart transplantation, a bridge-to-recovery, or as destination 53 therapy (i.e., as the last resort in patients with neither perspectives of recovery, nor heart 54 transplant). Implantable LVAD intended for long-term use rely on a percutaneous driveline, 55 to carry electric signals and energy from the controller and batteries to the implanted pump.…”

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confidence: 99%

Left ventricular assist device-related infections: a multicentric study

Siméon

Flécher

Revest

et al. 2017

Clinical Microbiology and Infection

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21Objectives. Implantable left ventricular assist device (LVAD) is a major therapeutic progress 22 for end-stage heart failure in selected patients. As their use is expanding, infectious 23 complications are emerging, with limited data available to guide their management. We 24 aimed to better characterize LVAD-related infections. 25Methods. We enrolled all consecutive patients diagnosed with LVAD-related infections in 3 26 referral centers in France, using standardized definition of infections in patients with LVAD. 27Data were collected from medical charts using a standardized questionnaire. with the use of prolonged antibacterial treatment in 34 (94%), and debridement in 17 (47%). 40One patient died due to LVAD-associated infection. 41Conclusions. LVAD-related infections are common after LVAD implantation, and may be 42 controlled by prolonged antibiotic treatment.

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confidence: 99%

Left ventricular assist device-related infections: a multicentric study

Siméon

Flécher

Revest

et al. 2017

Clinical Microbiology and Infection

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“…We conducted a semi-systematic review, which revealed that the target paper disappeared for certain items when the research quality conditions were narrowed down; therefore, we removed these conditions and chose 6 reports related to events [11][12][13][14][15][16]. We additionally selected 2 Japanese reports on re-hospitalization [17,18], which has a large impact on the health care system but could not be found in our current review.…”

Section: Long-term Prognosis Of Cost Effectivenessmentioning

confidence: 99%

Preliminary report on the cost effectiveness of ventricular assist devices

et al. 2015

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The aim of the present study was to perform a cost-effectiveness analysis (CEA) of ventricular assist devices (VAD) implantation surgery in the Japanese medical reimbursement system. The study group consisted of thirty-seven patients who had undergone VAD implantation surgery for dilated cardiomyopathy (n = 25; 67.6 %) or hypertrophic cardiomyopathy (n = 4; 10.8 %), and others (n = 8; 21.6 %). Quality-adjusted life years (QALYs) were calculated using the utility score and years of life. Medical reimbursement bills were chosen as cost indices. The observation period was the 12-month period after surgery. Then, the incremental cost-effectiveness ratio was calculated according to the VAD type. In addition, the prognosis after 36 months was estimated on the basis of the results obtained using the Markov chain model. The mean preoperative INTERMACS profile score was 2.35 ± 0.77. Our results showed that the utility score, which indicates the effectiveness of VAD implantation surgery, improved by 0.279 ± 0.188 (ΔQALY, p < 0.05). The cost of VAD implantation surgery was 313,282 ± 25,275 (ΔUS$/year) on the basis of medical reimbursement bills associated with therapeutic interventions. The calculated result of CEA was 364,501 ± 190,599 (ΔUS$/QALY). The improvement in the utility score was greater for implantable versus extracorporeal VADs (0.233 ± 0.534 vs. 0.371 ± 0.238) and ICER was 303,104 (ΔUS$/ΔQALY). Furthermore, when we estimated CEA for 36 months, the expected baseline value was 102,712 (US$/QALY). Therefore, VAD implantation surgery was cost effective considering the disease specificities.

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“…[1][2][3] With their approval for use as destination therapy (DT) and the improvement in mechanical durability of the newer devices, average support times have surpassed 12 months, 1,3,4 and device exchange owing to complications will inevitably be required for a variety of indications. 5,6 Although uncommon, device malfunction requiring replacement is a serious and potentially fatal complication. 2,5 Several risk factors have been identified, such as the use of first-generation devices, obesity, older age and renal failure.…”

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confidence: 99%

“…5,6 Although uncommon, device malfunction requiring replacement is a serious and potentially fatal complication. 2,5 Several risk factors have been identified, such as the use of first-generation devices, obesity, older age and renal failure. 1,7 To our knowledge, no Canadian centre has reported on their experience with these cases, thus far.…”

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confidence: 99%

Left ventricular assist device exchange: the Toronto General Hospital experience

Tsubota

Ribeiro

Billia

et al. 2017

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Background:As support times for left ventricular assist devices (LVADs) become longer, several complications requiring device exchange may occur. To our knowledge, this is the first Canadian report regarding implantable LVAD exchange. Methods:We retrospectively reviewed the cases of consecutive, unique patients implanted with an LVAD between June 2006 and October 2015 at Toronto General Hospital. Results:In total, 122 patients were impanted with an LVAD during the study period. Eight patients required LVAD exchange, and 1 patient had 2 replacements (9 of 122, 7.3%). There were 7 HeartMate II (HMII), 1 HVAD and 1 DuraHeart pumps exchanged. Two of these exchanges occurred early at the time of initial implant, whereas 7 occurred late (range 8-623 d). Six exchanges were made owing to pump thrombosis. Of the 3 exchanges made for other causes, 1 HMII exchange was owing to a driveline fracture, 1 DuraHeart patient had early inflow obstruction requiring exchange to HMII at the initial implant, and the third had a suspected inflow obstruction with no evidence of thrombosis at the time of the procedure. The mean support time before exchange was 225 days, and time from exchange to transplant, death or ongoing support was 245 days. Three patients were successfully bridged to transplant, and at the time of data collection 2 were supported awaiting transplant. Three patients died after a mean duration of 394.3 days (range 78-673 d) of support postreplacement. Four cases were successfully performed using a subcostal approach. Conclusion:Pump thrombosis is the most common cause for LVAD exchange, which can be performed with acceptable morbidity and mortality. The subcostal approach may be the preferred procedure for an HMII exchange when indicated.Contexte : À mesure que la durée d'utilisation des dispositifs d'assistance ventriculaire gauche (DAVG) augmente, plusieurs complications nécessitant un remplacement du dispositif peuvent survenir. À notre connaissance, il s'agit du premier rapport canadien concernant le remplacement des DAVG implantables.Méthodes : Nous avons passé en revue de manière rétrospective les cas individuels consécutifs de patients à qui on a implanté un DAVG entre juin 2006 et octobre 2015 à l'Hôpital Général de Toronto.Résultats : En tout, 122 patients ont reçu un DAVG pendant la période de l'étude. Huit patients ont eu besoin d'un remplacement de DAVG et 1 patient a eu besoin de 2 remplacements (9 sur 122, 7,3 %). Sept dispositifs HeartMate II (HMII), 1 dispositif HVAD et 1 dispositif DuraHeart ont été remplacés. Deux de ces remplacements sont survenus peu de temps après la pose initiale du dispositif, tandis que les 7 autres se sont produits plus tardivement (dans les 8 à 623 jours suivants). Six remplacements ont été effectués en raison d'une thrombose de la pompe. Parmi les 3 remplacements effectués pour d'autres raisons, 1 dispositif HMII a été remplacé en raison d'un bris de la ligne d'activation, 1 dispositif DuraHeart a présenté une obstruction précoce du flux entrant nécessitant la pose d'un HMII...

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Durability of left ventricular assist devices: Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) 2006 to 2011

Abstract: The Analysis of Interagency Registry for Mechanically Assisted Circulatory Support data showed greater durability for continuous flow than for pulsatile left ventricular assist devices. Even longer durations of support can be expected if pump durability continues to improve.

Cited by 66 publications

References 16 publications

Left ventricular assist device-related infections: a multicentric study

Left ventricular assist device-related infections: a multicentric study

Preliminary report on the cost effectiveness of ventricular assist devices

Left ventricular assist device exchange: the Toronto General Hospital experience

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