Document Detail


Predictor of Early Mortality for Severe Heart Failure Patients With Left Ventricular Assist Device Implantation.
MedLine Citation:
PMID:  22484979     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: The preoperative risk factors for left ventricular assist device (LVAD) implantation and their impact on the clinical outcome was analyzed to evaluate the optimal timing of LVAD implantation for severe heart failure patients. Methods and Results: From January 2006 to August 2011, 82 patients underwent 84 LVAD implantations at the Osaka University Hospital. These patients were categorized into 2 groups: Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) level 1 (n=41) and INTERMACS level 2/3 (n=43). The preoperative characteristics, early mortality, and cumulative survival between the 2 groups was compared. Ten (24.4%) patients died within 90 days in the INTERMACS level 1 group (multiple organ failure: 6, cerebrovascular event: 3, sepsis: 1), whereas 1 (2.3%) patient died because of a cerebrovascular event in the INTERMACS level 2/3 group (P=0.003). The cumulative survival rate was 82.9% at 30 days, 75.6% at 90 days, and 63.7% after 1 year in the INTERMACS level 1 group, and 100%, 97.7%, and 85.3% in the level 2/3 group (P=0.015). Using multivariate analysis for the INTERMACS level 1 group data, the preoperative serum creatinine level was the independent predictor of 90-day mortality. Conclusions: LVAD implantation in a stable condition contributes to better clinical outcome for severe heart failure patients. If critical cardiogenic shock occurs, LVAD implantation must be considered immediately before other organs' functions, especially renal function, deteriorate.
Authors:
Daisuke Yoshioka; Taichi Sakaguchi; Shunsuke Saito; Shigeru Miyagawa; Hiroyuki Nishi; Yasushi Yoshikawa; Satsuki Fukushima; Tetsuya Saito; Takashi Daimon; Takayoshi Ueno; Toru Kuratani; Yoshiki Sawa
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-7
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  -     ISSN:  1347-4820     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine.
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