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Oscar Braun

Physician

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Continuous-flow LVADs in the Nordic countries : complications and mortality and its predictors

Author

  • Oscar Ö. Braun
  • Johan Nilsson
  • Finn Gustafsson
  • Göran Dellgren
  • Arnt E. Fiane
  • Karl Lemström
  • Laila Hubbert
  • Laila Hellgren
  • Lars H. Lund

Summary, in English

Objectives: The purpose of this study was to assess complications and mortality and its predictors, with continuous-flow left ventricular assist devices (CF-LVADs) in the Nordic Countries. Design: This was a retrospective, international, multicenter cohort study. Results: Between 1993 and 2013, 442 surgically implanted long-term mechanical assist devices were used among 8 centers in the Nordic countries. Of those, 238 were CF-LVADs (HVAD or HeartMate II) implanted in patients >18 years with complete data. Postoperative complications and survival were compared and Cox proportion hazard regression analysis was used to identify predictors of mortality. The overall Kaplan–Meier survival rate was 75% at 1 year, 69% at 2 years and 63% at 3 years. A planned strategy of destination therapy had poorer survival compared to a strategy of bridge to transplantation or decision (2-year survival of 41% vs. 76%, p <.001). The most common complications were non-driveline infections (excluding sepsis) (44%), driveline infection (27%), need for continuous renal replacement therapy (25%) and right heart failure (24%). In a multivariate model age and left ventricular diastolic dimension was left as independent risk factors for mortality with a hazard ratio of 1.35 (95% confidence interval (CI) [1.01–1.80], p =.046) per 10 years and 0.88 (95% CI [0.72–0.99], p =.044) per 5 mm, respectively. Conclusion: Outcome with CF LVAD in the Nordic countries was comparable to other cohorts. Higher age and destination therapy require particularly stringent selection.

Department/s

  • Cardiology
  • Thoracic Surgery
  • Artificial Intelligence and Bioinformatics in Cardiothoracic Sciences (AIBCTS)
  • eSSENCE: The e-Science Collaboration

Publishing year

2019-03-05

Language

English

Pages

14-20

Publication/Series

Scandinavian Cardiovascular Journal

Volume

53

Issue

1

Document type

Journal article

Publisher

Taylor & Francis

Topic

  • Cardiac and Cardiovascular Systems

Keywords

  • Heart failure
  • left ventricular assist device
  • mechanical circulatory support
  • outcomes

Status

Published

Research group

  • Artificial Intelligence and Bioinformatics in Cardiothoracic Sciences (AIBCTS)

ISBN/ISSN/Other

  • ISSN: 1401-7431