Long‐term outcomes of elderly patients receiving continuous flow left ventricular support

Abstract

Background: Heart failure is an epidemic affecting over 6 million people in the United States. Eighty percent of all heart failure patients are older than 65 years of age. Heart transplant is the gold standard treatment for patients suffering advanced heart failure, but only 18.5% of patients receiving heart transplant in the United States are 65 years of age or older. Continuous-flow left ventricular assist devices are a safe and effective therapy for patients with advanced heart failure, and can be used to bridge patients to a heart transplant or to support patients long-term as destination therapy. Material and Methods: We sought to characterize long-term outcomes of elderly patients receiving continuous-flow left ventricular support in our program. Conclusion: Elderly patients with advanced heart failure presented comparable operative results to those of younger patients. The rate of complications up to 6 years of support was low, and comparable to those of younger patients. An

Mechanical circulatory support devices in geriatric patients: more than just age

“…Brozzi et al [12 ▪ ] conducted a retrospective study to characterize the long-term outcomes of elderly patients (age >65 years) who received durable LVAD and reported that elderly LVAD recipients had comparable operative outcomes and comparable incidence of major complications, such as gastrointestinal bleeding (24%), drive line infection (13%) and stroke (8%) with younger patients. However, except for patients in INTERMACS profile 1 (Table 1), patients in profiles 2 and 3, had significantly low hospital mortality (50, 10 and 0%, respectively).…”

Left ventricular assist devices in the elderly: Marching forward with cautions

“…Data from Brozzi's group 3 and others 9 support the importance of pre‐implant status in determining the hospital mortality of these elderly patients: the less moribund, the better the survival. Therefore, early referral to advanced heart failure and VAD centers is crucial.…”

“…In this issue of the Journal of Cardiac Surgery, Brozzi et al 3 reviewed long‐term outcomes of 43 elderly patients (age >65 years) who received continuous‐flow (CF) LVADs with 84% received a Heartmate 2 (Abbott Laboratories) and 16%, a Heartware HVAD (Medtronic Inc.) from a single center over a 6‐year period. The average age was 71.5 years, and most patients were in a non‐ambulatory state: 14% were in the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) Profile 1 and 70% Profile 2.…”

Long‐term outcomes of elderly patients receiving continuous flow left ventricular support

“…To the Editor, The article titled "Long-term outcomes of elderly patients receiving continuous flow left ventricular support" by Brozzi et al 1 was read carefully and attentively due to its high quality and scientific contribution to the medical community. We agree with the authors that the left ventricular assist device (LVAD) should be administered to patients with a low probability of receiving cardiac transplantation.…”