Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Sandner, SE; Zimpfer, D; Zrunek, P; Rajek, A; Schima, H; Dunkler, D; Zuckermann, AO; Wieselthaler, GM.
Age and outcome after continuous-flow left ventricular assist device implantation as bridge to transplantation.
J Heart Lung Transplant. 2009; 28(4):367-72
Doi: 10.1016/j.healun.2009.01.008
Web of Science
PubMed
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- Co-Autor*innen der Med Uni Graz
- Zimpfer Daniel
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- Abstract:
- OBJECTIVE: The effect of age on outcomes after continuous-flow left ventricular assist device (LVAD) implantation as a bridge to transplantation (BTT) was determined. METHODS: From November 1998 to July 2007, 86 patients with advanced heart failure underwent continuous-flow LVAD implantation as BTT and were retrospectively analyzed. Patients were categorized into 2 groups by age at LVAD implantation: 56 patients (65.1%) younger than 60, Group 1; and 30 (34.9%) aged 60 years or older, Group 2. RESULTS: Group 2 patients had a higher incidence of heart failure caused by ischemic heart disease (63.3% vs 32.1%, p = 0.005) and more severely impaired renal function by Modification of Diet in Renal Disease-derived glomerular filtration rates (51.9 +/- 15.9 vs. 68.0 +/- 20.5 ml/min/1.73 m(2), p < 0.001) than Group 1. Age was the only independent predictor of post-LVAD death (hazard ratio, 1.4 p = 0.003). The BTT rate was lower (33.3% vs 62.5%, p = 0.010), and incidence of post-LVAD renal failure was higher (53.3% vs 30.4%, p = 0.037) in Group 2 vs Group 1. Post-LVAD survival at 1, 3, and 6 months was 92.9%, 79.9%, and 74.0% for Group 1 and 90.0%, 62.0%, and 37.0% for Group 2 (p = 0.007). Post-transplant survival at 1, 3, and 5 years was 87.8%, 82.3%, and 76.0% for Group 1 and 90.0%, 67.5%, 67.5% for Group 2 (p = 0.517). CONCLUSIONS: Patients aged 60 years and older have inferior post-LVAD survival; however, post-transplant survival is excellent. We advocate LVAD placement as bridge-to-transplant therapy only in carefully selected older patients most well suited for transplantation.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult - administration & dosage
- Age Factors - administration & dosage
- Aged - administration & dosage
- Female - administration & dosage
- Heart Failure - surgery
- Heart Transplantation - mortality, physiology
- Heart-Assist Devices - administration & dosage
- Humans - administration & dosage
- Male - administration & dosage
- Middle Aged - administration & dosage
- Retrospective Studies - administration & dosage
- Survival Analysis - administration & dosage
- Survivors - administration & dosage
- Ventricular Dysfunction, Left - complications, mortality, surgery, therapy