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Outcomes and Complications after Left Ventricular Assist Device Implantation.
Wasilewski, Grzegorz; Wisniowska-Smialek, Sylwia; Górkiewicz-Kot, Izabela; Milaniak, Irena; Kaleta, Michal; Hymczak, Hubert; Tomsia, Paulina; Wierzbicki, Karol.
Afiliación
  • Wasilewski G; Department of Cardiovascular Surgery and Transplantology, Jagiellonian University, Medical College, St. John Paul II Hospital, Cracow, Poland. Electronic address: grzegorz.wa@interia.pl.
  • Wisniowska-Smialek S; Department of Cardiovascular Surgery and Transplantology, Jagiellonian University, Medical College, St. John Paul II Hospital, Cracow, Poland.
  • Górkiewicz-Kot I; Department of Cardiovascular Surgery and Transplantology, Jagiellonian University, Medical College, St. John Paul II Hospital, Cracow, Poland.
  • Milaniak I; Department of Cardiovascular Surgery and Transplantology, Jagiellonian University, Medical College, St. John Paul II Hospital, Cracow, Poland.
  • Kaleta M; Department of Cardiovascular Surgery and Transplantology, Jagiellonian University, Medical College, St. John Paul II Hospital, Cracow, Poland.
  • Hymczak H; Department of Cardiovascular Surgery and Transplantology, Jagiellonian University, Medical College, St. John Paul II Hospital, Cracow, Poland.
  • Tomsia P; Department of Cardiovascular Surgery and Transplantology, Jagiellonian University, Medical College, St. John Paul II Hospital, Cracow, Poland.
  • Wierzbicki K; Department of Cardiovascular Surgery and Transplantology, Jagiellonian University, Medical College, St. John Paul II Hospital, Cracow, Poland.
Transplant Proc ; 56(4): 864-867, 2024 May.
Article en En | MEDLINE | ID: mdl-38734516
ABSTRACT

BACKGROUND:

Heart transplantation is the treatment of choice for selected patients with end-stage heart failure. Persistent donor organ shortage causes a growing demand for mechanical circulatory support not only as a bridge to transplantation but mainly as a destination therapy (DT).

METHODS:

The aim of the study was to analyze the indications, comorbidities, and complications during the follow-up of all patients undergoing left ventricular assist device (LVAD) implantation with at least 12 months of follow-up time in one of the most experienced clinics in Poland between 2015 and 2023.

RESULTS:

There were 125 individuals with LVAD implantation, from which 90 had full 12 months of follow-up (85 males - 94%, 5 females - 6%), with a median age of 58 (50.25-63.75) years. The median body mass index was 27.12 (25.27-29.68). The etiology of heart failure was ischemic (n = 44, 49%), dilated cardiomyopathy (n = 44, 49%), and others. Preoperative echocardiography revealed a mean LV ejection fraction of 13.8% and a median LV dimension of 7.55 (6.92-8.2) cm. In 61 patients (68%), imaging confirmed pulmonary hypertension. Thirty-four patients (38%) had diabetes and 16 (18%) were active smokers. Median follow-up was 30 (17.25-42) months, with the longest period being about 82 months. 40 (44%) patients had kidney failure before LVAD implantation, and in 43 cases (48%), we observed relevant, transient deterioration of kidney function. Almost all patients (n = 82, 91%) suffered from anemia (Hb <13 g/dL in males and <12 g/dL in females) in different periods after LVAD implantation due to perioperative bleeding, gastrointestinal bleeding or unknown causes. The lowest Hb level was observed in the first week after LVAD implantation in 53 cases (58%). Median red cell concentrate transfusion demand before the discharge after surgery was 6 (2-8, 5) units.

CONCLUSIONS:

Appropriate selection of candidates and timing of LVAD implantation are critical for improved outcomes of DT. Anemia and kidney failure are the most frequent follow-up complications. Improved results and increased applicability and durability of LVADs have established this treatment option as an excellent alternative for patients with end-stage heart failure.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Corazón Auxiliar / Insuficiencia Cardíaca Límite: Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Transplant Proc Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Corazón Auxiliar / Insuficiencia Cardíaca Límite: Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Transplant Proc Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos