Department of Cardiovascular Surgery and Transplantology, Jagiellonian University, Cracow, Poland.
Department of Cardiovascular Surgery and Transplantology, Jagiellonian University, Cracow, Poland.
Transplant Proc. 2022 May;54(4):1049-1053. doi: 10.1016/j.transproceed.2022.02.020. Epub 2022 Apr 15.
Donor organ shortage caused a growing interest in mechanical circulatory support not only as a bridge to transplant but also as a destination therapy. Improved results and increased applicability and durability of left ventricular assist devices (LVADs) have established this treatment option as an alternative for patients with end-stage heart failure.
The aim of the study was to compare the early results, major complications, and the follow up of all patients undergoing HeartMate3 (HM3) LVAD and HeartWare Ventricular Assist Device (HVAD) system implantation in one of the most experienced Clinic in Poland between 2015 and 2020.
There were 78 individuals (72 male, 92%; 6 female, 8%), with median age 57 years (range, 50-62 years). Until 2020 we implanted 47 (60%) HVADs and 31 (40%) HM3 LVADs. Patient characteristics were comparable between both groups apart from median left ventricle diameter (8.2 cm [range, 7.4-8.4 cm] in HM3 group vs 7.2 cm [range, 6.7-7.9 cm] in HVAD group; P < .01) The overall survival was 53.2% in the HVAD group and 77.4% in the HM3 group (P =.03). Mean survival time was higher in HM3 group (2.97 years [range, 2.43-3.5 years] vs 2.51 years [range, 1.94-3.08 years]; P < .05). Mean complication-free survival time was also higher in the HM3 group (2.16 years [range, 1.55-2.76] vs 1.61 [range, 1.16-2.06 years]; P < .05), with overall complication-free rate of 54.8% for HM3 vs 29.8% for HVAD (P = .27). Median hospitalization time was comparable (31 days [range, 25-39 days] in the HM3 group vs 32 days [range, 24-38 days] in the HVAD group; P = .49).
Patients supported with the HM3 had significantly fewer major complications than HVAD. Moreover, the HVAD was associated with higher mortality.
供体器官短缺导致人们对机械循环支持越来越感兴趣，不仅将其作为移植的桥梁，而且还将其作为一种治疗选择。左心室辅助装置（LVAD）的结果改善以及适用性和耐用性的提高，使这种治疗选择成为终末期心力衰竭患者的另一种选择。
本研究的目的是比较 2015 年至 2020 年间在波兰最有经验的一家诊所中，所有接受 HeartMate3（HM3）LVAD 和 HeartWare 心室辅助装置（HVAD）系统植入的患者的早期结果、主要并发症和随访情况。
共有 78 名患者（72 名男性，92%；6 名女性，8%），中位年龄 57 岁（范围，50-62 岁）。到 2020 年，我们共植入 47 例（60%）HVAD 和 31 例（40%）HM3 LVAD。两组患者的特征除左心室直径中位数（HM3 组为 8.2cm[范围，7.4-8.4cm]，HVAD 组为 7.2cm[范围，6.7-7.9cm]；P<.01）外，其余均相似。HVAD 组的总体生存率为 53.2%，HM3 组为 77.4%（P=.03）。HM3 组的平均生存时间更高（2.97 年[范围，2.43-3.5 年]与 2.51 年[范围，1.94-3.08 年]；P<.05）。HM3 组无并发症的平均生存时间也更高（2.16 年[范围，1.55-2.76]与 1.61 年[范围，1.16-2.06 年]；P<.05），HM3 的总体无并发症率为 54.8%，HVAD 为 29.8%（P=.27）。HM3 组的中位住院时间与 HVAD 组相当（31 天[范围，25-39 天]与 32 天[范围，24-38 天]；P=.49）。
接受 HM3 治疗的患者发生主要并发症的情况明显少于 HVAD 治疗的患者。此外，HVAD 与较高的死亡率相关。
