Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
Department of Medicine, Tufts Medical Center, Boston, Massachusetts.
Ann Thorac Surg. 2018 Mar;105(3):696-701. doi: 10.1016/j.athoracsur.2017.08.057. Epub 2017 Dec 2.
Long-term survivors after implantation of left ventricular assist devices (LVADs) are increasing in prevalence. We describe the characteristics and outcomes in patients surviving longer than 4 years on LVAD support.
We performed a multicenter, retrospective analysis of patients surviving at least 4 years on continuous-flow LVAD (CF-LVAD) support with a HeartMate II at centers participating in the Evolving Mechanical support Research Group.
Between 2005 and 2010, 156 long-term survivors were identified with a mean survival of 7.1 years (95% confidence interval: 6.7 to 7.5 years). The mean age was 58.2 ± 15.2 years and 30.1% were women. Readmission rate was low at 1.1 events per patient per year with the most common reasons leading to readmission being infection (0.10 readmissions per patient per year) and gastrointestinal bleeding (0.07 readmissions per patient per year). Two years after implantation, 97% of patients were either New York Heart Association functional class I or II, with 92% at 4 years.
Patients surviving 4 years on CF-LVAD support can anticipate ongoing long-term survival with sustained improvements in functionality and low rates of rehospitalization.
植入左心室辅助装置(LVAD)后的长期幸存者越来越多。我们描述了在 LVAD 支持下存活超过 4 年的患者的特征和结局。
我们对至少在连续流动 LVAD(CF-LVAD)支持下存活 4 年以上的患者进行了一项多中心回顾性分析,这些患者在参与 Evolving Mechanical support Research Group 的中心使用 HeartMate II。
2005 年至 2010 年间,确定了 156 名长期幸存者,平均存活时间为 7.1 年(95%置信区间:6.7 至 7.5 年)。平均年龄为 58.2±15.2 岁,30.1%为女性。再入院率为每年每患者 1.1 次,再入院的最常见原因是感染(每年每患者 0.10 次)和胃肠道出血(每年每患者 0.07 次)。植入后 2 年,97%的患者为纽约心脏协会功能 I 级或 II 级,4 年后为 92%。
在 CF-LVAD 支持下存活 4 年的患者可以预期长期持续生存,并持续改善功能,再入院率低。