Merzo Abraham, Dalén Magnus, Kristensen Ann Hallberg, Melin Michael, Faxén Jonas, Edfors Robert, Najjar Emil
Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Department of Medicine and Cardiology, Malarsjukhuset, Eskilstuna, Sweden.
JHLT Open. 2024 Apr 8;4:100093. doi: 10.1016/j.jhlto.2024.100093. eCollection 2024 May.
To descriptively present data and outcomes of left ventricular assist device (LVAD) implantations at Karolinska University Hospital.
Data were collected from consecutive patients ( = 44) who were implanted with HeartMate 3 (HM3) at Karolinska University Hospital between 2017 and 2022. The study presents baseline characteristics, clinical course during the inpatient hospital care after implantation, adverse events, and clinical outcomes.
Median intensive care unit stay and hospital stay after HM3 implantation was 8 (interquartile range [IQR] 6; 15) and 28 days (IQR 22; 36), respectively. In total, 73% underwent ramp test at some point after the implantation. Death from all causes within 30 days postimplantation was 5%. A total of 21 patients (48%) underwent right heart catheterization, at a median of 0.5 years (IQR 0.3; 0.7) after implantation, and all exhibited optimally unloaded left ventricles. During the study period, 34% of the patients were transplanted, 5% were explanted, and 16% died with LVAD. In total, 11% and 5% suffered from early and late right ventricle failures, respectively. Acute renal failure affected 46% and 18% had driveline infection. Spontaneous cerebral hemorrhage and cerebral infarction affected 5% and 7% of the study population, respectively. Gastrointestinal bleeding affected 16%. The median LVAD duration was 10 months (IQR 5; 22). The 1-year survival rate with LVAD was 85%, and the 2-year survival rate was 80%.
The results of this low-volume single-center retrospective study on LVAD implantations align with the results of other studies and international registries.
描述卡罗林斯卡大学医院左心室辅助装置(LVAD)植入的数据和结果。
收集了2017年至2022年期间在卡罗林斯卡大学医院连续植入HeartMate 3(HM3)的患者(n = 44)的数据。该研究展示了基线特征、植入后住院期间的临床过程、不良事件和临床结果。
HM3植入后重症监护病房的中位住院时间和住院时间分别为8天(四分位间距[IQR] 6;15)和28天(IQR 22;36)。总共73%的患者在植入后的某个时间点进行了递增测试。植入后30天内的全因死亡率为5%。共有21名患者(48%)在植入后中位0.5年(IQR 0.3;0.7)时接受了右心导管检查,所有患者的左心室均达到最佳卸载状态。在研究期间,34%的患者接受了移植,5%的患者装置被移除,16%的患者带着LVAD死亡。总共分别有11%和5%的患者发生早期和晚期右心室衰竭。急性肾衰竭影响了46%的患者,18%的患者发生了驱动线感染。自发性脑出血和脑梗死分别影响了5%和7%的研究人群。胃肠道出血影响了16%的患者。LVAD的中位使用时间为10个月(IQR 5;22)。带LVAD的1年生存率为85%,2年生存率为80%。
这项关于LVAD植入的小样本单中心回顾性研究结果与其他研究及国际登记处的结果一致。