Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Dimitrov, K; Kaider, A; Angleitner, P; Schlöglhofer, T; Gross, C; Beitzke, D; Granegger, M; Riebandt, J; Wiedemann, D; Sandner, S; Schaefer, AK; Schima, H; Laufer, G; Zimpfer, D.
Incidence, clinical relevance and therapeutic options for outflow graft stenosis in patients with left ventricular assist devices.
Eur J Cardiothorac Surg. 2022; 61(3): 716-724.
Doi: 10.1093/ejcts/ezab382
Web of Science
PubMed
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- Führende Autor*innen der Med Uni Graz
- Zimpfer Daniel
- Co-Autor*innen der Med Uni Graz
- Beitzke Dietrich
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- Abstract:
- OBJECTIVES: We reviewed our institutional experience with outflow graft stenosis (OGS) in 3 contemporary left ventricular assist devices (LVAD). METHODS: Data from 347 consecutive adult recipients of LVAD [Medtronic HVAD (n = 184, 53.0%), Abbott HeartMate II (n = 62, 17.9%) and Abbott HeartMate 3 (n = 101, 29.1%)] implanted between March 2006 and October 2019 were analysed retrospectively. Primary study end points were the incidence of OGS necessitating treatment and survival on LVAD support. RESULTS: During the study period, 17 patients (4.9%) developed OGS requiring treatment with a probability of 0.6% at 1 year, 1.9% at 2 years, 3.8% at 3 years, 4.7% at 4 years and 5.9% at 5 years of LVAD support. Notably, in 13.8% of patients, a compression-related narrowing of the outflow graft with a probability of 1.5% at 6 months, 1.8% 1 year, 6.0% at 2 years, 12.3% at 3 years, 15.4% at 4 years and 16.6% at 5 years of LVAD support with no difference between devices (P = 0.26) was observed. There was a trend towards increased risk of mortality with OGS (hazard ratio 2.21, 95% confidence interval 0.87-5.51; P = 0.09). OGS preferentially occurred in segments of the outflow graft covered by a protective coating. CONCLUSIONS: OGS is a rare but potentially lethal complication during LVAD support. Modifications of pump design and implant techniques may be needed because OGS preferentially occurs within covered portions of the outflow graft. Systematic screening may be warranted.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult - administration & dosage
- Constriction, Pathologic - etiology
- Heart Failure - etiology, surgery
- Heart-Assist Devices - adverse effects
- Humans - administration & dosage
- Incidence - administration & dosage
- Retrospective Studies - administration & dosage
- Find related publications in this database (Keywords)
- Bend relief
- Computed tomography angiography
- Graft occlusion
- Intervention
- Left ventricular assist device
- Mechanical circulatory support
- Outflow graft stenosis
- Outflow graft
- Ventricular assist device