Abstract
Background and aimHeart failure is still a leading cause of mortality and morbidity. Assist devices are reserved for advanced heart failure patients with no other therapeutic options.We aim in this paper to describe the characteristics and outcome of Lebanese left ventricular assist device (LVAD) patients.ResultsFrom 2010 till December 2019, 78 patients were implanted with assist devices at the Beirut cardiac Institute, 82 pumps were used. To the most recent follow up after 10 years, 26 patients died (34%). 24 patients of 35 (68%) survived more than 5 years. Seven patients only (9%) died during one month of surgery. One year mortality was 19% (15 patients). The leading cause of early mortality was infection, whereas cerebrovascular accidents CVA were the leading cause of late mortality. Pump thrombosis occurred in 12% of the cases. The most serious long term complication was haemorrhagic CVA. Only seven patients (9%) received heart transplantation, with a mean time on support prior to transplantation of 1303 ± 213 days.ConclusionIn this manuscript we reported the characteristics and outcome of the largest population of LVAD patients in Lebanon. The survival rate was 81% at one year. These findings were comparable to the international registries except for rates of heart transplantation. More efforts should be made to encourage organ donation in Lebanon.
Highlights
Heart failure mortality and morbidity remains very high
We aim in this paper to describe the characteristics and outcome of left ventricular assist device (LVAD) patients in the Beirut Cardiac Institute center, that is the main local institute that has the largest experience in LVAD in Lebanon
Definitions -Pump thrombosis was defined according to the INTE RMACS (Inter Agency Registry for Mechanically Assisted Circulatory Support) definition [2] by: Alterations in pump parameters defined as unexpected power increase with higher than expected flow estimation (“pseudo -flow”) or a precipitous drop in flow and power and/or increase in biochemical markers of hemolysis, including Lactate dehydrogenase (LDH) > 2 times the upper limit, or pfHgb > 40 mg/ dl or hemoglobinuria and /or Visualization of organized fibrin in the pump housing after exchange of the LVAD and /or abnormal pump sounds identified by auscultation
Summary
Heart failure mortality and morbidity remains very high. In Lebanon we encounter three majors challenges for this therapy beside the complications that are: the cost, the delayed referral of patients to advanced hear failure units, and the lack of organ donation. We aim in this paper to describe the characteristics and outcome of LVAD patients in the Beirut Cardiac Institute center, that is the main local institute that has the largest experience in LVAD in Lebanon. Heart failure is still a leading cause of mortality and morbidity. Assist devices are reserved for advanced heart failure patients with no other therapeutic options. We aim in this paper to describe the characteristics and outcome of Lebanese left ventricular assist device (LVAD) patients
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