Abstract
PurposeThe purpose was to assess outcomes with durable continuous-flow left ventricular assist device (LVAD) in Scandinavia.MethodsSince 1993, 497 durable LVADs have been implanted among 9 centers in Scandinavia. Of those, 273 were 2nd and 3rd generation LVAD, 80% as bridge to transplant. We performed a retrospective analysis of 252 patients with complete data. Postoperative complications and survival, with censorship at transplantation, were compared between groups and Cox proportion hazard regression analysis was used to identify factors associated with reduced long-term survival.ResultsThe actuarial survival rate was 71%, 64% and 62% at 1 year, 3 years and 5 years respectively and similar for 2nd and 3rd generation LVADs (Figure). The most common complication were drive line infection (24%), right heart failure (24%), gastrointestinal bleeding (11%), pump thrombosis (9%) and thromboembolic events (8%) (Table), again similar for 2nd and 3rd generations LVADs. Univariable predictors of mortality were higher age, creatinine, bilirubin and lower platelet count and pulmonary vascular resistance.ConclusionPrognosis after continuous flow LVAD in Scandinavia is modest. Careful selection considering markers of renal insufficiency and liver congestion as well as previously reported risk markers may improve the risk / benefit ratio.
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