Abstract

Introduction: Bridge to transplant (BTT) with left ventricular assist devices (LVADs) are the most common treatment strategy for advanced heart failure patients. Under the 2018 revised heart allocation system in the United States, stable LVAD patients are anticipated to stay longer on the waiting list as they are lower relative priority for heart transplantation (HTx). However, little is known regarding long-term trajectory of functional capacity (FC) and health-related quality of life (HR-QOL) following LVAD implantation. Methods: We retrospectively analyzed 442 consecutive patients who received the HeartMate II LVADs as BTT between April 2013 and May 2019 and were followed at least 12 months from the Japanese Mechanically Assisted Circulatory Support registry. FC (NYHA functional class, peak oxygen uptake [VO 2 ] and 6-mimutes walk test [6MWT]) and HR-QOL (European Quality of Life [EQ-5D index] and Visual Analogue Scale [VAS]) were assessed at baseline and up to 60 months after LVAD implantation. Results: During the follow-up period of 30 (IQR 18-42) months, 100 (22.6%) patients were transplanted, 37 (8.3%) died, and 14 (3.1%) were explanted for recovery. Three hundred and forty-three (77.6%) patients had NYHA class IV at baseline. Following LVAD implantation, 86% of patients at 3 months and 87% at 60 months improved to NYHA class I or II. Mean peak VO 2 , 6MWT distance, EQ-5D index and VAS were significantly improved at 3 months after LVAD implantation ( P = 0.0012, P = 0.0037, P <0.001, P <0.001, respectively). Furthermore, these improvements were sustained up to 60 months following LVAD implantation (Figure A-D). Adverse events including device failure, infection, stroke and bleeding occurred within 3 months after LVAD implantation did not affect FC or HR-QOL up to 60 months ( P = 0.69, P = 0.40, respectively). Conclusions: Patients who received LVADs showed long-term preservation of FC and HR-QOL, suggesting that BTT-LVAD may remain an option despite a longer time to HTx.

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call

Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.