Advanced Heart Failure

Truby, Lauren K.; Rogers, Joseph G.

doi:10.1016/j.jchf.2020.01.014

Cited by 207 publications

(132 citation statements)

References 10 publications

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“…In the current era, there is a growing gap between the number of advanced heart failure patients waiting for an HTx and the limited availability of donor organs [ 24 , 25 ]. In this context, continuous-flow implantable LVADs could represent a life-saving therapy.…”

Section: Discussionmentioning

confidence: 99%

Impact of Continuous Flow Left Ventricular Assist Device on Heart Transplant Candidates: A Multi-State Survival Analysis

Carrozzini

Bottio²,

Caraffa³

et al. 2022

JCM

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(1) Objectives: The aim of this study was to investigate the impact of the prolonged use of continuous-flow left ventricular assist devices (LVADs) on heart transplant (HTx) candidates. (2) Methods: Between January 2012 and December 2019, we included all consecutive patients diagnosed with end-stage heart failure considered for HTx at our institution, who were also eligible for LVAD therapy as a bridge to transplant (BTT). Patients were divided into two groups: those who received an LVAD as BTT (LVAD group) and those who were listed without durable support (No-LVAD group). (3) Results: A total of 250 patients were analyzed. Of these, 70 patients (28%) were directly implanted with an LVAD as BTT, 11 (4.4%) received delayed LVAD implantation, and 169 (67%) were never assisted with an implantable device. The mean follow-up time was 36 ± 29 months. In the multivariate analysis of survival before HTx, LVAD implantation showed a protective effect: LVAD vs. No-LVAD HR 0.01 (p < 0.01) and LVAD vs. LVAD delayed HR 0.13 (p = 0.02). Mortality and adverse events after HTx were similar between LVAD and No-LVAD (p = 0.65 and p = 0.39, respectively). The multi-state survival analysis showed a significantly higher probability of death for No-LVAD vs. LVAD patients with (p = 0.03) or without (p = 0.04) HTx. (4) Conclusions: The use of LVAD as a bridge to transplant was associated with an overall survival benefit, compared to patients listed without LVAD support.

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Section: Discussionmentioning

confidence: 99%

Impact of Continuous Flow Left Ventricular Assist Device on Heart Transplant Candidates: A Multi-State Survival Analysis

Carrozzini

Bottio²,

Caraffa³

et al. 2022

JCM

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“…The prevalence, socioeconomic and clinical burden of chronic heart failure with reduced left ventricular (LV) ejection fraction (HFrEF) is exponentially growing [ 1 ]. Ventricular tachycardia (VT) frequently occurs in patients with HFrEF, and is not only a phenotype of structural heart disease [ 2 ] but may indicate progression of heart failure and risk of decompensation.…”

Section: Commentarymentioning

confidence: 99%

Outcomes of mechanical circulatory support for ventricular tachycardia ablation in severe systolic heart failure

Napp

Basir

2021

J Interv Card Electrophysiol

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“…End-stage heart failure (ESHF) is a major healthcare issue. Heart transplant (HT) represents the gold standard treatment, but it is limited by the shortage of available organs [ 1 , 2 , 3 , 4 ]. The results with LVAD implantation have significantly improved thanks to the advancement in technologies [ 5 , 6 , 7 , 8 , 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

A Device Strategy-Matched Comparison Analysis among Different Intermacs Profiles: A Single Center Experience

Caraffa

Bejko

Carrozzini

et al. 2022

JCM

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Background: The present study evaluates outcomes of LVAD patients, taking into account the device strategy and the INTERMACS profile. Methods: We included 192 LVAD-patients implanted between January 2012 and May 2021. The primary and secondary end-points were survival and major adverse events between Profiles 1–3 vs. Profile 4, depending on implantation strategies (Bridge-to-transplant-BTT; Bridge-to-candidacy-BTC; Destination-Therapy-DT). Results: The overall survival was 67% (61–75) at 12 months and 61% (54–70) at 24 months. Profile 4 patients showed significantly higher survival (p = 0.018). Incidences of acute right-ventricular- failure (RVF) (p = 0.046), right-ventricular-assist-device (RVAD) implantation (p = 0.015), and continuous-venovenous-hemofiltration (CVVH) (p = 0.006) were higher in Profile 1–3 patients, as well as a longer intensive care unit stays (p = 0.050) and in-hospital-mortality (p = 0.012). Twelve-month and 24-month survival rates were higher in the BTT rather than in BTC (log-rank = 0.410; log-rank = 0.120) and in DT groups (log-rank = 0.046). In the BTT group, Profile 1–3 patients had a higher need for RVAD support (p = 0.042). Conclusion: LVAD implantation in elective patients was associated with better survival and lower complications incidence. LVAD implantation in BTC patients has to be considered before their conditions deteriorate. DT should be addressed to elective patients in order to guarantee acceptable results.

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Advanced Heart Failure

Cited by 207 publications

References 10 publications

Impact of Continuous Flow Left Ventricular Assist Device on Heart Transplant Candidates: A Multi-State Survival Analysis

Impact of Continuous Flow Left Ventricular Assist Device on Heart Transplant Candidates: A Multi-State Survival Analysis

Outcomes of mechanical circulatory support for ventricular tachycardia ablation in severe systolic heart failure

A Device Strategy-Matched Comparison Analysis among Different Intermacs Profiles: A Single Center Experience

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