Age and Outcome After Continuous-Flow Left Ventricular Assist Device Implantation as Bridge to Transplantation

Sandner, Sigrid; Zimpfer, Daniel; Zrunek, Philipp; Rajek, Angela; Schima, Heinrich; Dunkler, Daniela; Zuckermann, Andreas; Wieselthaler, Georg

doi:10.1016/j.healun.2009.01.008

Cited by 51 publications

(61 citation statements)

References 35 publications

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“…4,9 Yet, older age is a risk factor for decreased survival after MCS 9 , including DT MCS, 8 and is associated with increased morbidity after MCS (e.g., renal failure, stroke and gastrointestinal bleeding). 10,11 Health-related quality of life (HRQOL) outcomes also improve through 2 years after MCS. [12][13][14][15] However, adverse events and symptoms after MCS are risk factors for poor HRQOL and their increased incidence in older patients may diminish the HRQOL benefits in this population.…”

mentioning

confidence: 99%

Change in Health-related Quality of Life from Before to After Destination Therapy Mechanical Circulatory Support is Similar for Older and Younger Patients: Analyses from INTERMACS

Grady

Naftel

Myers

et al. 2014

The Journal of Heart and Lung Transplantation

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mentioning

confidence: 99%

Change in Health-related Quality of Life from Before to After Destination Therapy Mechanical Circulatory Support is Similar for Older and Younger Patients: Analyses from INTERMACS

Grady

Naftel

Myers

et al. 2014

The Journal of Heart and Lung Transplantation

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“…Advanced age is currently the most common contraindication to heart transplantation and affects one-third of all patients receiving MCS devices. In general, elderly patients who receive MCS tend to have a higher prevalence of ischemic cardiomyopathy [8][9][10], diabetes, and concomitant renal dysfunction than younger MCS recipients [11]. Quantifying the attributable risk of age on morbidity and mortality is complex and has been the subject of several retrospective analyses [8-10, 12, 13].…”

Section: Impact Of Age On Mcs Outcomesmentioning

confidence: 99%

“…The cause of death among all patients receiving MCS as destination therapy is fairly evenly distributed across multiorgan failure, CNS events, hemorrhage, and cardiac failure [4]. Small studies evaluating cause of death among elderly patients receiving MCS for destination therapy suggest an excess mortality due to sepsis, stroke [11,14], and multiorgan failure [10].…”

Section: Mortalitymentioning

confidence: 99%

Mechanical circulatory support for elderly heart failure patients

Butler

Jugdutt

2012

Heart Fail Rev

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End-stage systolic heart failure is an increasingly common problem in elderly patients and is associated with high cost, poor quality of life, and poor outcomes. Mechanical circulatory support is a promising therapy as both a bridge to transplantation and destination therapy. Elderly patients are frequently ineligible for heart transplantation because of their age and comorbidities, and the application of mechanical circulatory support for destination therapy in this population is not well defined. A review of the literature was undertaken to better characterize our experience to date with mechanical circulatory support in older heart failure populations. Mechanical circulatory support is being employed increasingly for destination therapy indications in older patients. The newer continuous flow devices appear to have disproportionate advantage in elderly patients, which has translated into marked improvement in 1- and 2-year survival. The rational implementation of MCS devices in elderly heart failure patients needs to focus on (1) continuous flow devices that appear to have particular benefit in this population, (2) extensive pre-MCS assessment including variables relating to frailty, and (3) intervening before these patients develop cardiogenic shock. More data are needed on the cost-benefit analysis of routine use of CF devices as destination therapy in elderly patients with heart failure.

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“…27,28 Patients Eligible for Heart Transplant Listed Status I-Indication for LVAD Implantable devices have totally revised the landscape of the waiting list for cardiac transplantation. Through the 1980s, the waiting list trembled under the shadows of sudden death or hemodynamic decompensation before transplantation.…”

Section: More Lvads In Elderly Patients?mentioning

confidence: 99%