Daniel Lewin , Sebastian V. Rojas MD , Michael Billion MD , Anna L. Meyer MD , Ivan Netuka MD , Janajade Kooij MD , Marina Pieri MD , Antonio Loforte MD , Mariusz K. Szymanski MD , Christian H. Moeller MD , Payam Akhyari MD , Khalil Jawad MD , Ihor Krasivskyi MD , Bastian Schmack MD , Gloria Färber MD , Marta Medina MD , Assad Haneya MD , Daniel Zimpfer MD , Gaik Nersesian MD , Mehmet Oezkur MD , Evgenij V. Potapov MD
{"title":"使用或不使用体外生命支持微轴流泵进行临时循环支持后的耐用左心室辅助装置","authors":"Daniel Lewin , Sebastian V. Rojas MD , Michael Billion MD , Anna L. Meyer MD , Ivan Netuka MD , Janajade Kooij MD , Marina Pieri MD , Antonio Loforte MD , Mariusz K. Szymanski MD , Christian H. Moeller MD , Payam Akhyari MD , Khalil Jawad MD , Ihor Krasivskyi MD , Bastian Schmack MD , Gloria Färber MD , Marta Medina MD , Assad Haneya MD , Daniel Zimpfer MD , Gaik Nersesian MD , Mehmet Oezkur MD , Evgenij V. Potapov MD","doi":"10.1016/j.xjon.2024.06.021","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Circulatory support with a catheter-based microaxial flow pump (mAFP) plays a major role in the treatment of severe cardiogenic shock. In most patients who fail to recover while on temporary mechanical circulatory support (tMCS) and who are not eligible for heart transplantation, durable left ventricular assist device (dLVAD) implantation is usually considered a reliable option. This study aimed to describe the outcome of dLVAD therapy following mAFP support and to identify predictors of mortality.</div></div><div><h3>Methods</h3><div>This was a retrospective analysis of data from a multicenter registry on patients who underwent dLVAD implantation following tMCS with a mAFP between January 2017 and October 2022 (n = 332) from 19 European centers.</div></div><div><h3>Results</h3><div>Patients were supported with an Impella 5.5 (n = 92), 5.0 (n = 153) or CP (n = 87) and were transitioned to a HeartWare HVAD (n = 128) or Heartmate 3 (n = 204) during the same period. One hundred and twenty-five patients (39.2%) also required extracorporeal life support before and/or during mAFP therapy. The 30-day and 1-year survival were 87.8% and 71.1%, respectively. The following risk factors for 1-year mortality were identified: age (odds ratio [OR], 1.02), specifically age over 55 years (OR, 1.09), body mass index >30 kg/m<sup>2</sup> (OR, 2.2), female sex (OR for male sex, 0.43), elevated total bilirubin (OR, 1.12), and low platelet count (OR, 0.996).</div></div><div><h3>Conclusions</h3><div>Based on the identified risk factors, a risk score for estimating 1-year mortality was calculated to optimize patient selection for dLVAD implantation.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"21 ","pages":"Pages 168-179"},"PeriodicalIF":0.0000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Durable left ventricular assist devices following temporary circulatory support on a microaxial flow pump with and without extracorporeal life support\",\"authors\":\"Daniel Lewin , Sebastian V. Rojas MD , Michael Billion MD , Anna L. Meyer MD , Ivan Netuka MD , Janajade Kooij MD , Marina Pieri MD , Antonio Loforte MD , Mariusz K. Szymanski MD , Christian H. Moeller MD , Payam Akhyari MD , Khalil Jawad MD , Ihor Krasivskyi MD , Bastian Schmack MD , Gloria Färber MD , Marta Medina MD , Assad Haneya MD , Daniel Zimpfer MD , Gaik Nersesian MD , Mehmet Oezkur MD , Evgenij V. Potapov MD\",\"doi\":\"10.1016/j.xjon.2024.06.021\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Circulatory support with a catheter-based microaxial flow pump (mAFP) plays a major role in the treatment of severe cardiogenic shock. In most patients who fail to recover while on temporary mechanical circulatory support (tMCS) and who are not eligible for heart transplantation, durable left ventricular assist device (dLVAD) implantation is usually considered a reliable option. This study aimed to describe the outcome of dLVAD therapy following mAFP support and to identify predictors of mortality.</div></div><div><h3>Methods</h3><div>This was a retrospective analysis of data from a multicenter registry on patients who underwent dLVAD implantation following tMCS with a mAFP between January 2017 and October 2022 (n = 332) from 19 European centers.</div></div><div><h3>Results</h3><div>Patients were supported with an Impella 5.5 (n = 92), 5.0 (n = 153) or CP (n = 87) and were transitioned to a HeartWare HVAD (n = 128) or Heartmate 3 (n = 204) during the same period. One hundred and twenty-five patients (39.2%) also required extracorporeal life support before and/or during mAFP therapy. The 30-day and 1-year survival were 87.8% and 71.1%, respectively. The following risk factors for 1-year mortality were identified: age (odds ratio [OR], 1.02), specifically age over 55 years (OR, 1.09), body mass index >30 kg/m<sup>2</sup> (OR, 2.2), female sex (OR for male sex, 0.43), elevated total bilirubin (OR, 1.12), and low platelet count (OR, 0.996).</div></div><div><h3>Conclusions</h3><div>Based on the identified risk factors, a risk score for estimating 1-year mortality was calculated to optimize patient selection for dLVAD implantation.</div></div>\",\"PeriodicalId\":74032,\"journal\":{\"name\":\"JTCVS open\",\"volume\":\"21 \",\"pages\":\"Pages 168-179\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JTCVS open\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S266627362400202X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JTCVS open","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S266627362400202X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Durable left ventricular assist devices following temporary circulatory support on a microaxial flow pump with and without extracorporeal life support
Background
Circulatory support with a catheter-based microaxial flow pump (mAFP) plays a major role in the treatment of severe cardiogenic shock. In most patients who fail to recover while on temporary mechanical circulatory support (tMCS) and who are not eligible for heart transplantation, durable left ventricular assist device (dLVAD) implantation is usually considered a reliable option. This study aimed to describe the outcome of dLVAD therapy following mAFP support and to identify predictors of mortality.
Methods
This was a retrospective analysis of data from a multicenter registry on patients who underwent dLVAD implantation following tMCS with a mAFP between January 2017 and October 2022 (n = 332) from 19 European centers.
Results
Patients were supported with an Impella 5.5 (n = 92), 5.0 (n = 153) or CP (n = 87) and were transitioned to a HeartWare HVAD (n = 128) or Heartmate 3 (n = 204) during the same period. One hundred and twenty-five patients (39.2%) also required extracorporeal life support before and/or during mAFP therapy. The 30-day and 1-year survival were 87.8% and 71.1%, respectively. The following risk factors for 1-year mortality were identified: age (odds ratio [OR], 1.02), specifically age over 55 years (OR, 1.09), body mass index >30 kg/m2 (OR, 2.2), female sex (OR for male sex, 0.43), elevated total bilirubin (OR, 1.12), and low platelet count (OR, 0.996).
Conclusions
Based on the identified risk factors, a risk score for estimating 1-year mortality was calculated to optimize patient selection for dLVAD implantation.
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