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Outcome of mechanical circulatory support at the University Medical Centre Utrecht

Felix, SEA; Ramjankhan, FZ; Buijsrogge, MP; Jacob, KA; Asselbergs, FW; Oerlemans, MIF; Kirkels, JH; ... de Jonge, N; + view all (2020) Outcome of mechanical circulatory support at the University Medical Centre Utrecht. Netherlands Heart Journal 10.1007/s12471-020-01375-4. Green open access

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Background The prevalence of heart failure (HF) is increasing substantially and, despite improvements in medical therapy, HF still carries a poor prognosis. Mechanical circulatory support (MCS) by a continuous-flow left ventricular assist device (cf-LVAD) improves survival and quality of life in selected patients. This holds especially for the short-term outcome, but experience regarding long-term outcome is growing as the waiting time for heart transplantation is increasing due to the shortage of donor hearts. Here we present our results from the University Medical Centre Utrecht. Methods Data of all patients with a cf-LVAD implant between March 2006 and January 2018 were collected. The primary outcome was survival. Secondary outcomes included adverse events defined according to the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) definitions, described per patient year. Results A total of 268 patients (69% male, mean age 50 ± 13 years) received a cf-LVAD. After a median follow-up of 542 (interquartile range 205–1044) days, heart transplantation had been performed in 82 (31%) patients, the cf-LVAD had been explanted in 8 (3%) and 71 (26%) had died. Survival at 1, 3 and 5 years was 83%, 72% and 57%, respectively, with heart transplantation, cf-LVAD explantation or death as the end-point. Death was most often caused by neurological complications (31%) or infection (20%). Major bleeding occurred 0.51 times and stroke 0.15 times per patient year. Conclusion Not only short-term results but also 5‑year survival after cf-LVAD support demonstrate that MCS is a promising therapy as an extended bridge to heart transplantation. However, the incidence of several major complications still has to be addressed.

Type: Article
Title: Outcome of mechanical circulatory support at the University Medical Centre Utrecht
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s12471-020-01375-4
Publisher version: https://doi.org/10.1007/s12471-020-01375-4
Language: English
Additional information: This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
Keywords: Science & Technology, Life Sciences & Biomedicine, Cardiac & Cardiovascular Systems, Cardiovascular System & Cardiology, Mechanical circulatory support, Outcome, Complications, VENTRICULAR ASSIST DEVICE, STAGE HEART-FAILURE, EUROPEAN REGISTRY, TRANSPLANTATION, IMPLANTATION, VALIDATION, SOCIETY, FOCUS, PUMP
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics
URI: https://discovery.ucl.ac.uk/id/eprint/10094776
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