Document Detail


Preoperative risk factors for mortality after biventricular assist device implantation.
MedLine Citation:
PMID:  19041048     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A right ventricular assist device is a treatment option for patients with severe right ventricular failure after left ventricular assist device (LVAD) implantation. Recognition of risk factors for mortality after biventricular assist device (BiVAD) implantation is important for patient selection and optimal outcomes. METHODS: We reviewed our experiences between 1991 and 2005 in 44 patients who were supported by both an LVAD and a right ventricular assist device. RESULTS: Thirteen patients (30%) survived until heart transplantation, and 31 patients (70%) died while on support. The multivariate analysis shows that post-LVAD extracorporeal membrane oxygenation and worsening renal function are associated with the highest postoperative mortality. The univariate analysis also included previous thoracic surgery and ischemic cardiomyopathy as potential preoperative indicators for poor outcome after BiVAD implants. No differences were observed in the rates for the need of preoperative support with a ventilator, an intra-aortic balloon pump, or extracorporeal membrane oxygenation, or in the rates of postoperative complications between survivors and nonsurvivors. CONCLUSIONS: BiVAD implantation remains one of the challenges in treating severe heart failure. Previous cardiac surgery, elevated creatinine, and post-LVAD extracorporeal membrane oxygenation were risk factors for mortality after BiVAD implantation. Dialated Cardiomyopathy on the other hand was associated with a more favorable outcome.
Authors:
Firas Zahr; Yoshio Ootaki; Randall C Starling; Nicholas G Smedira; Mohamad Yamani; Lucy Thuita; Kiyotaka Fukamachi
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-10-14
Journal Detail:
Title:  Journal of cardiac failure     Volume:  14     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-01     Completed Date:  2009-06-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  844-9     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Heart Failure / mortality,  physiopathology,  surgery
Heart-Assist Devices / adverse effects,  trends*
Humans
Male
Middle Aged
Preoperative Care / adverse effects,  trends*
Prosthesis Implantation / adverse effects,  trends*
Retrospective Studies
Risk Factors
Survival Rate / trends
Treatment Outcome
Ventricular Dysfunction, Left / mortality,  physiopathology,  surgery*
Ventricular Dysfunction, Right / mortality,  physiopathology,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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