Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany; Clinic for Heart Surgery, Heart Center, Leipzig University, Leipzig, Germany.
Advanced Heart Failure and Cardiac Transplant Service, Royal Perth Hospital, Perth, Western Australia, Australia.
J Heart Lung Transplant. 2014 May;33(5):486-91. doi: 10.1016/j.healun.2014.01.856. Epub 2014 Jan 24.
The post-market Registry to Evaluate the HeartWare Left Ventricular Assist System (ReVOLVE) is an investigator-initiated registry established to collect post-CE Mark Trial clinical data on patients receiving a HeartWare ventricular assist device (HVAD) in the European Union and Australia.
The ReVOLVE is a multi-center, prospective, single-arm registry performed at seven centers in Europe and two in Australia. Herein we describe a total of 254 commercial HVAD implants according to labeled indications between February 2009 and November 2012. Summary statistics included patients' demographics, adverse events, length of support and outcomes.
Compared with the clinical trial supporting the CE Mark of the HeartWare system, patient selection differed in that patients were older, and there were higher proportions of females and patients with idiopathic cardiomyopathies in the ReVOLVE cohort. Duration of support ranged from 1 to 1,057 days, with a mean of 363 ± 280 days (median 299.5 days). Transplantation was done in 56 patients (22%), explant for recovery was performed in 3 patients (1%), 43 died while on support (17%), and 152 (60%) remain on the device. Success in patients with the HeartWare system was 87% at 6 months, 85% at 1 year, 79% at 2 years and 73% at 3 years. Adverse event rates were low, comparable or improved when compared to the CE Mark Trial.
Real-world use of the HeartWare system continues to demonstrate excellent clinical outcomes in patients supported with the device.
HeartWare 左心室辅助系统(ReVOLVE)上市后注册研究是一项由研究者发起的注册研究,旨在收集在欧盟和澳大利亚接受 HeartWare 心室辅助装置(HVAD)治疗的患者的 CE 标志后临床试验数据。
ReVOLVE 是一项多中心、前瞻性、单臂注册研究,在欧洲的 7 个中心和澳大利亚的 2 个中心进行。在此,我们根据标签适应证描述了总共 254 例商业 HVAD 植入病例,这些病例发生在 2009 年 2 月至 2012 年 11 月期间。汇总统计数据包括患者的人口统计学特征、不良事件、支持时间和结局。
与支持 HeartWare 系统 CE 标志的临床试验相比,患者选择有所不同,ReVOLVE 队列中的患者年龄更大,女性和特发性心肌病患者的比例更高。支持时间从 1 天到 1057 天不等,平均 363 ± 280 天(中位数 299.5 天)。56 例患者(22%)接受了移植,3 例患者(1%)进行了恢复性心脏切除术,43 例患者在支持过程中死亡(17%),152 例患者(60%)仍在使用该设备。6 个月时,患者 HeartWare 系统的成功率为 87%,1 年时为 85%,2 年时为 79%,3 年时为 73%。不良事件发生率较低,与 CE 标志试验相比,结果相当或改善。
在接受 HeartWare 系统治疗的患者中,真实世界的数据继续显示出该设备出色的临床结局。