Worldwide Gender Differences during Mechanical Circulatory Support: An Analysis of the International Society for Heart and Lung Transplantation Mechanically Assisted Circulatory Support Registry Data

Abstract

Purpose The aim of this study is to investigate gender differences of patients on mechanical circulatory support (MCS) using data of the ISHLT Mechanically Assisted Circulatory Support (IMACS) registry. We hypothesize that gender differences lead to differences in implantation data, perioperative complication rates as well as in mid- and longterm outcome among patients undergoing MCS therapy and that these outcomes differ between continents. Methods The study was performed using the IMACS registry database. Patients receiving right (temporary or permanent) or left ventricular assist devices and patients with biventricular assist devices were included leading to a total number of 17329 patients. Gender-specific survival curves were drawn using the Kaplan-Meier method and using the log-rank test to test the equality of the survival curves. Results We included 17329 patients who underwent MCS, either with left ventricular support only or additional right ventricular support. Mean patients age was 54.2 ± 15.4 years and did not differ significantly between the two groups. The majority of the patients was male (78.2%). In both groups most of the devices were implanted to bridge the patients to transplantation (60.5% female vs 57.9% male). There was a significant difference regarding need of temporary right ventricular support (2.6% female vs 2 % male; p=0.048) and women underwent significantly more frequent implantation of biventricular mechanical support (6.6% female vs 4.6% male; p Conclusion In this largest study to date focusing on gender and intercontinental differences we found significant differences in pre-, peri- and longterm results among male and female LVAD recipients. These results may guide physicians and caregivers in better understanding gender specific differences.