MEDICAL MANAGEMENT AFTER DISCHARGE IN LVADS WITH CONTINUOUS VERSUS PULSATILE FLOW: DIFFERENT DRUGS FOR DIFFERENT PUMPS?

Abstract

Continuous and pulsatile left ventricular assist devices (LVAD) provide different signals that could lead to altered neurohormonal response. We hypothesized that this change in response may lead to different medical management post implant. Methods. Patients who had 3 months follow-up after LVAD implant were included. In 18 patients with continuous flow LVAD implantation (C group) and 33 patients with pulsatile LVAD (P group) data for mean blood pressure (MBP), creatinine, diuretics and antihypertensive drugs were collected at 1, 3, 6 and 12 months. Results. Average duration of LVAD support was similar between the two groups 372±276 days in C group vs. 344±246 days in P group, P=0.725. Serum creatinine levels (mg/dL) and MBP (mmHg) are listed in the table. Significantly more patients in C group were on diuretics at 1 month (14/18 vs. 12/33 patients, P=0.005) and 3 months (14/15 vs. 15/33 patients, P=0.002). At 6 months, significantly more patients in P group were on antihypertensive medications, 29/31 vs. 7/12 patients in C group, P=0.012.TableConclusion. These data indicate a temporary difference in medication needs related to the type of LVAD used. At one year, there is adjustment leading to disappearance of this difference.