Prediction of Survival After Implantation of a Fully Magnetically Levitated Left Ventricular Assist Device

Mehra, Mandeep R.; Nayak, Aditi; Morris, Alanna A.; Lanfear, David E.; Nemeh, Hassan; Desai, Sapna; Bansal, Aditya; Guerrero‐Miranda, Cesar; Hall, Shelley; Cleveland, Joseph C.; Goldstein, Daniel J.; Uriel, Nir; Chen, Leway; Bailey, Stephen; Anyanwu, Anelechi C.; Heatley, Gerald J.; Chuang, Joyce; Estep, Jerry D.

doi:10.1016/j.jchf.2022.08.002

Cited by 41 publications

(24 citation statements)

References 35 publications

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“…Patients enrolled in that trial were highly selected and may not reflect the real-world patients who are receiving durable LVAD implantation. For instance, in the study reported et al 28 , ~35% of patients INTERMACS profile 1 or 2. Our study included 254 (6.59%) ECMO patients and 273 (7.09%) on mechanical ventilation before LVAD implantation.…”

Section: Discussionmentioning

confidence: 87%

“…Recently, a HM3 risk score (HM3RS) has been reported. Mehra et al 28 identified age, prior cardiac surgery, lower serum sodium, BUN, small ventricular size, and RAP to pulmonary capillary wedge pressure as significant risk factors for mortality. The AUC of the HM3RS was 0.76 for 1 year mortality.…”

Section: Discussionmentioning

confidence: 99%

“…The AUC of the HM3RS was 0.76 for 1 year mortality. 28 This predictive score was developed using standard logistic regression. Importantly, different from our analysis, the HM3RS used data from a clinical trial.…”

Section: Discussionmentioning

confidence: 99%

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Predicting Survival of End-Stage Heart Failure Patients Receiving HeartMate-3: Comparing Machine Learning Methods

Loyaga-Rendon,

Acharya,

Jani

et al. 2023

ASAIO Journal

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HeartMate 3 is the only durable left ventricular assist devices (LVAD) currently implanted in the United States. The purpose of this study was to develop a predictive model for 1 year mortality of HeartMate 3 implanted patients, comparing standard statistical techniques and machine learning algorithms. Adult patients registered in the Society of Thoracic Surgeons, Interagency Registry for Mechanically Assisted Circulatory Support (STS-INTERMACS) database, who received primary implant with a HeartMate 3 between January 1, 2017, and December 31, 2019, were included. Epidemiological, clinical, hemodynamic, and echocardiographic characteristics were analyzed. Standard logistic regression and machine learning (elastic net and neural network) were used to predict 1 year survival. A total of 3,853 patients were included. Of these, 493 (12.8%) died within 1 year after implantation. Standard logistic regression identified age, Model End Stage Liver Disease (MELD)-XI score, right arterial (RA) pressure, INTERMACS profile, heart rate, and etiology of heart failure (HF), as important predictor factors for 1 year mortality with an area under the curve (AUC): 0.72 (0.66–0.77). This predictive model was noninferior to the ones developed using the elastic net or neural network. Standard statistical techniques were noninferior to neural networks and elastic net in predicting 1 year survival after HeartMate 3 implantation. The benefit of using machine-learning algorithms in the prediction of outcomes may depend on the type of dataset used for analysis.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

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Predicting Survival of End-Stage Heart Failure Patients Receiving HeartMate-3: Comparing Machine Learning Methods

Loyaga-Rendon,

Acharya,

Jani

et al. 2023

ASAIO Journal

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“…In the left ventricular assist device (LVAD) field, the MOMENTUM3 investigators provided a survival score that may assist heart failure physicians in decision-making, which patient may benefit most from LVAD therapy. 70 Funding None.…”

Section: Glimpse Into Surgery Of the Aorta And For Terminal Heart Fai...mentioning

confidence: 99%

Cardiac Surgery 2022 Reviewed

Doenst,

Schneider,

Caldonazo

et al. 2023

Thorac Cardiovasc Surg

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PubMed displayed almost 37,000 hits for the search term “cardiac surgery AND 2022.” As before, we used the PRISMA approach and selected relevant publications for a results-oriented summary. We focused on coronary and conventional valve surgery, their overlap with interventional alternatives, and briefly assessed surgery for aorta or terminal heart failure. In the field of coronary artery disease (CAD), key manuscripts addressed prognostic implications of invasive treatment options, classically compared modern interventions (percutaneous coronary intervention [PCI]) with surgery (coronary artery bypass grafting [CABG]), and addressed technical aspects of CABG. The general direction in 2022 confirms the superiority of CABG over PCI in patients with anatomically complex chronic CAD and supports an infarct-preventative effect as underlying mechanism. In addition, the relevance of proper surgical technique to achieve durable graft patency and the need for optimal medical treatment in CABG patients was impressively illustrated. In structural heart disease, the comparisons of interventional and surgical techniques have been characterized by prognostic and mechanistic investigations underscoring the need for durable treatment effects and reductions of valve-related complications. Early surgery for most valve pathologies appears to provide significant survival advantages, and two publications on the Ross operation prototypically illustrate an inverse association between long-term survival and valve-related complications. For surgical treatment of heart failure, the first xenotransplantation was certainly dominant, and in the aortic surgery field, innovations in arch surgery prevailed. This article summarizes publications perceived as important by us. It cannot be complete nor free of individual interpretation, but provides up-to-date information for decision-making and patient information.

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“…In the medical field, the Heartmate 3 currently stands as the only commercially available LVAD. While outcomes are excellent, 13,14 rivaling transplant in ways that were unthinkable when the Jarvik Pivotal trial conducted, the lack of competition is a profound contributor to inertia in the field. The recent report of the Society for Thoracic Surgeons INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) database shows that the number of VAD implants in the United States has dramatically fallen since 2018 when stable VAD patients were reduced in priority to receive transplantation.…”

mentioning

confidence: 99%

Progress and Pitfalls: Lessons From the Jarvik 2000 Trial

Baran¹

2023

ASAIO Journal

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Prediction of Survival After Implantation of a Fully Magnetically Levitated Left Ventricular Assist Device

Cited by 41 publications

References 35 publications

Predicting Survival of End-Stage Heart Failure Patients Receiving HeartMate-3: Comparing Machine Learning Methods

Predicting Survival of End-Stage Heart Failure Patients Receiving HeartMate-3: Comparing Machine Learning Methods

Cardiac Surgery 2022 Reviewed

Progress and Pitfalls: Lessons From the Jarvik 2000 Trial

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