Continuous-flow left ventricular assist devices linked to good long-term outcomes
Continuous-flow left ventricular assist devices (CF-LVAD) confer excellent long-term survival, with prolonged LVAD support reducing the risk of major bleeds, a new study has shown.
The study included 103 adult patients (mean age 50±13 years; 71 percent male) undergoing CF-LVAD implantation. Patient demographic, preoperative comorbidity, laboratory, operative, medication and complication information were collected and included in the analysis.
Readmission information included interventional procedures required, length of stay and diagnosis. Elective transplant readmissions were excluded. Kaplan-Meier curves were used for survival analyses.
Over a mean follow-up of at least 2 years, overall mortality rate was only 29 percent (n=30), to which death during admission contributed the most (18 percent; n=19). The 30-day, 1-year and 2-year mortality rates were 14 (n=14), 23 (n=24) and 26 (n=27) percent, respectively.
Among the 37 patients who received prolonged LVAD support, there were 129 readmission events corresponding to 1,499 hospital days. Readmission at least once was reported in 29 patients, while nine were readmitted at least five times. There were four patients who were readmitted at least nine times.
The most common cause of readmission was major infections. All patients who were readmitted had at least one infection event. Seven patients had recurrent infections, while 15 had major infections during prolonged LVAD support.
Only postoperative infections were significantly associated with readmission (p=0.03). All-cause bleeding, ventricular arrhythmia and other complications after the operation were not significantly correlated with readmission. Mortality rates were also not significantly different between those who were readmitted and those who were not.