Impact of preoperative extracorporeal life support on left ventricular assist device outcomes : A comparative study
BACKGROUND: To investigate whether preoperative short-term extracorporeal life support therapy in patients undergoing continuous-flow left ventricular assist device implantation has an impact on the outcome regarding survival and adverse events.
METHODS: Between January 2011 and May 2018, 100 consecutive patients received HeartMate II, HeartWare, or HeartMate III for end-stage heart failure. Mean age was 64.2 ± 10.3 years. Three patient groups were identified: without preoperative extracorporeal life support (non-extracorporeal life support group, n = 80), with preoperative extracorporeal life support due to postcardiotomy shock after conventional cardiac surgery (postcardiotomy shock group, n = 9), and with preoperative extracorporeal life support without previous surgery (non-postcardiotomy shock group, n = 11). The primary endpoint was overall survival after device implantation. Secondary endpoints were adverse events during the follow-up period.
RESULTS: Survival was significantly different between the groups (p < 0.05): 30-day, 6-month, and 1-year survival rates were 85%, 68%, and 61% for non-extracorporeal life support group; 44%, 22%, and 22% for postcardiotomy shock group; and 45%, 27%, and 24% for non-postcardiotomy shock group, respectively. Furthermore, in both extracorporeal life support groups (postcardiotomy shock and non-postcardiotomy shock), there were a higher incidence (p < 0.05) of postoperative right heart failure (30% vs 66.7% vs 54.5%), acute renal failure requiring dialysis (20% vs 77.8% vs 54.5%), and respiratory failure (31.3% vs 88.9% vs 81.8%).
CONCLUSION: Continuous-flow left ventricular assist device implantation with prior extracorporeal life support appears to have a worse outcome regarding survival, right heart failure, renal and respiratory dysfunction (p < 0.05). Future studies have to be done to evaluate the outcome after extracorporeal life support bridge pre-left ventricular assist device, especially as ultima ratio in postcardiotomy shock patients.
Medienart: |
E-Artikel |
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Erscheinungsjahr: |
2019 |
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Erschienen: |
2019 |
Enthalten in: |
Zur Gesamtaufnahme - volume:42 |
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Enthalten in: |
The International journal of artificial organs - 42(2019), 7 vom: 10. Juli, Seite 338-346 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Zhigalov, Konstantin [VerfasserIn] |
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Links: |
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Themen: |
Cardiac assist and artificial heart |
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Anmerkungen: |
Date Completed 12.11.2019 Date Revised 08.04.2022 published: Print-Electronic Citation Status MEDLINE |
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doi: |
10.1177/0391398819837696 |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
NLM29541958X |
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100 | 1 | |a Zhigalov, Konstantin |e verfasserin |4 aut | |
245 | 1 | 0 | |a Impact of preoperative extracorporeal life support on left ventricular assist device outcomes |b A comparative study |
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500 | |a Citation Status MEDLINE | ||
520 | |a BACKGROUND: To investigate whether preoperative short-term extracorporeal life support therapy in patients undergoing continuous-flow left ventricular assist device implantation has an impact on the outcome regarding survival and adverse events | ||
520 | |a METHODS: Between January 2011 and May 2018, 100 consecutive patients received HeartMate II, HeartWare, or HeartMate III for end-stage heart failure. Mean age was 64.2 ± 10.3 years. Three patient groups were identified: without preoperative extracorporeal life support (non-extracorporeal life support group, n = 80), with preoperative extracorporeal life support due to postcardiotomy shock after conventional cardiac surgery (postcardiotomy shock group, n = 9), and with preoperative extracorporeal life support without previous surgery (non-postcardiotomy shock group, n = 11). The primary endpoint was overall survival after device implantation. Secondary endpoints were adverse events during the follow-up period | ||
520 | |a RESULTS: Survival was significantly different between the groups (p < 0.05): 30-day, 6-month, and 1-year survival rates were 85%, 68%, and 61% for non-extracorporeal life support group; 44%, 22%, and 22% for postcardiotomy shock group; and 45%, 27%, and 24% for non-postcardiotomy shock group, respectively. Furthermore, in both extracorporeal life support groups (postcardiotomy shock and non-postcardiotomy shock), there were a higher incidence (p < 0.05) of postoperative right heart failure (30% vs 66.7% vs 54.5%), acute renal failure requiring dialysis (20% vs 77.8% vs 54.5%), and respiratory failure (31.3% vs 88.9% vs 81.8%) | ||
520 | |a CONCLUSION: Continuous-flow left ventricular assist device implantation with prior extracorporeal life support appears to have a worse outcome regarding survival, right heart failure, renal and respiratory dysfunction (p < 0.05). Future studies have to be done to evaluate the outcome after extracorporeal life support bridge pre-left ventricular assist device, especially as ultima ratio in postcardiotomy shock patients | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a Left ventricular assist device | |
650 | 4 | |a cardiac assist and artificial heart | |
650 | 4 | |a extracorporeal life support | |
650 | 4 | |a heart failure | |
650 | 4 | |a mechanical circulatory support | |
700 | 1 | |a Szczechowicz, Marcin |e verfasserin |4 aut | |
700 | 1 | |a Mashhour, Ahmed |e verfasserin |4 aut | |
700 | 1 | |a Mkalaluh, Sabreen |e verfasserin |4 aut | |
700 | 1 | |a Safonov, Dmitrii |e verfasserin |4 aut | |
700 | 1 | |a Enginoev, Soslan |e verfasserin |4 aut | |
700 | 1 | |a Easo, Jerry |e verfasserin |4 aut | |
700 | 1 | |a Ennker, Juergen |e verfasserin |4 aut | |
700 | 1 | |a Eichstaedt, Harald C |e verfasserin |4 aut | |
700 | 1 | |a Weymann, Alexander |e verfasserin |4 aut | |
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