Does Age at The Time of LVAD Implantation Affect Post LVAD Implantation Survival? A Single Center Experience

Abstract

Use of left ventricular assist device (LVAD) therapy is proven to be effective for the treatment of advanced heart failure. Heart transplant is not an option for patients with advanced age, frequently defined as age 70 or greater. The purpose of this study was to compare the survival rate post LVAD implantation for between patients who were less than 70 years or 70 years or older. A retrospective review of patients implanted with an LVAD between March 2008 and February 2019 was conducted. 413 patients who received a continuous flow LVAD were included in the study. Patients were stratified by ≥70 years of age (n= 60) and <70 years of age (n=357). The post-implant survival time frames reviewed were 6 months, 1 year, and 2 years. The patients included in the study were implanted with a variety of LVADs, including Levacor, HeartMate 2, HeartMate 3, and HVAD devices. The overall survival rate was based on the Kaplan-Meier estimates and the Log-Rank test was used to compare the survival curves of the two groups. Table 1 contains baseline demographics and survival. There was no statistically significant survival difference between the two groups. Survival in the 18-69 group vs the ≥70 group at 6 months was 87.8% vs 83.3% (p 0.302). 1 year survival was 81.6% and 83.3% (p 0.793), and 2 year survival was 70.3% and 71.7% (p 0.629), respectively. Figure 1 shows the Kaplan-Meier curves for each group. LVAD recipients who were ≥70 years of age did not experience increased mortality compared to LVAD recipients who were 18-69 years of age. Patients should not be declined for LVAD therapy based on chronological age alone.