Heart failure in Poland: Left ventricular assist device destination therapy and other challenges of interventional cardiology and cardiac surgery

Kuśmierczyk, Mariusz; Różański, Jacek; Zembala, Michał; Dudek, Dariusz; Braksator, Wojciech; Grodzicki, Tomasz; Hoffmań, Piotr; Sadowski, Jerzy; Gruchała, Marcin; Legutko, Jacek; Siondalski, Piotr; Wierzbicki, Karol; Kapelak, Bogusław; Opolski, Grzegorz; Juraszek, Andrzej; Bondaryk, Katarzyna; Walczak, J; Pieniążek, Izabela; Grys, Maciej; Przygodzki, Piotr

doi:10.5603/cj.a2020.0148

Cited by 3 publications

(1 citation statement)

References 13 publications

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“…Stroke is the major cause of death between 6 and 24 months after LVAD implantation and occurs at a rate of 8.7% per year [ 79 ]. This incidence has been minimized in the recent 2-year outcome of the MOMEMTUM-3 trial with a total of 22 strokes occurring in 19 patients in the HM3 group (10.1%), contrasting with the 43 events that occurred in 33 (19.2%) patients in the HMII group (hazard ratio [HR] 0.47; p = 0.02) [ 5 , 80 ]. Ischemic strokes usually result from embolic sources on the aortic valve, the inflow cannula, or intracardiac chambers.…”

Section: Complicationsmentioning

confidence: 99%

Continuous-flow left ventricular assist device: Current knowledge, complications, and future directions

2022

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Section: Complicationsmentioning

confidence: 99%

Continuous-flow left ventricular assist device: Current knowledge, complications, and future directions

2022

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Patient-Related Preoperative Clinical Factors Influencing 1-Year Survival After Orthotopic Heart Transplantation – A Single Center Polish Experience

et al. 2022

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Background End-stage heart failure is a growing problem in Poland. Orthotopic heart transplantation remains the best treatment option. Although increasing, the number of heart transplants is disproportionately low compared with patient need. Therefore, it is crucial to identify factors contributing to improvement of heart transplantation outcomes. To find factors providing best survival and optimal recipient selection, we analyzed pretransplant patient-related clinical factors. Material/Methods Between May 2015 and May 2020, we performed 258 cardiac transplants at our institution. We reviewed possible patient-related clinical factors affecting the 1-year survival of our patients and analyzed factors related to survival. Mean age at transplant was 53.5 (±11.8) years; 22.9% of patients were women. Preoperative factors were analyzed using univariable and multivariable analyses. Results In this cohort, 31.8% were diabetic, 43% had ischemic etiology of heart failure, and 15.3% had reversible pulmonary hypertension. Mechanical circulatory support was used in 22%. During 1-year observation, 64 (24.8%) patients died. Univariable analysis showed ischemic etiology (hazard ratio [HR]=2.05, CI=1.227–3.429; P =0.01) and left ventricular assist device were associated with 1-year risk of death (HR=1.953, CI=1.090–3.499; P =0.02). Urgent listing trended toward worsened prognosis (HR=1.509, CI=0.95–2.397; P =0.08). Multivariable analysis showed ischemic etiology (HR=1.81, CI=1.075–3.059; P =0.03), total mechanical circulatory support (HR=1.93, CI=1.080–3.437; P =0.03), decreased eGFR (HR=0.987, CI=0.975–0.998; P =0.03), and protein level (HR=0.97, CI=0.951–0.998; P =0.04) were independently associated with worse 1-year survival after transplantation. Conclusions Ischemic etiology and mechanical circulatory support were the most important preoperative factors. Malnutrition and renal failure were additional risk factors. Age alone did not influence 1-year survival.

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The Role of Ventricular Assist Devices in Patients With Heart Failure Due to Dilated Cardiomyopathy: A Systematic Review

McBenedict,

Hauwanga,

Amadi

et al. 2024

Cureus

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Dilated cardiomyopathy (DCM) is a prevalent heart muscle disease characterized by ventricular dilation and systolic dysfunction, leading to severe heart failure (HF) and often requiring heart transplantation (HTx). This systematic review aimed to synthesize information regarding the role of ventricular assist devices (VADs) in managing HF patients due to DCM. A comprehensive search was conducted across PubMed, Embase, Scopus, Web of Science, and Cochrane databases for studies published between 2014 and 2024. Inclusion criteria were studies involving adult patients with HF due to DCM treated with VADs. Exclusion criteria included non-human studies, pediatric populations, and non-peer-reviewed articles. Thirty-one studies met the inclusion criteria. The included studies demonstrated that the use of VADs in patients with DCM resulted in significant improvements in left ventricular ejection fraction (LVEF), myocardial fibrosis reduction, and reverse ventricular remodeling. Studies reported enhanced survival rates, reduced symptoms, and better quality of life. VADs served as a critical bridge to HTx and, in some cases, as long-term destination therapy. However, complications such as thrombus formation, anemia, and kidney failure were noted, emphasizing the need for vigilant monitoring and management. Continuous advancements in VAD technology and patient management protocols were found to be essential for optimizing outcomes. We conclude that VADs play a crucial role in managing advanced HF due to DCM by providing mechanical circulatory support, improving cardiac function, and enhancing patient survival and quality of life. Despite associated complications, VADs are invaluable for patients with severe HF, offering both immediate and long-term therapeutic benefits. Future research should focus on minimizing complications and further improving VAD technology to enhance patient outcomes.

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Heart failure in Poland: Left ventricular assist device destination therapy and other challenges of interventional cardiology and cardiac surgery

Cited by 3 publications

References 13 publications

Continuous-flow left ventricular assist device: Current knowledge, complications, and future directions

Continuous-flow left ventricular assist device: Current knowledge, complications, and future directions

Patient-Related Preoperative Clinical Factors Influencing 1-Year Survival After Orthotopic Heart Transplantation – A Single Center Polish Experience

The Role of Ventricular Assist Devices in Patients With Heart Failure Due to Dilated Cardiomyopathy: A Systematic Review

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