Does A Pre-Left Ventricular Assist Device Screening Score Predict Long-Term Transplantation Success? A 2-Center Analysis

Authors

  • Brian Lima
  • Aftab R. Kherani
  • Jonathan A. Hata
  • Faisal H. Cheema
  • Jennifer Casher
  • Mehmet C. Oz
  • Vivek Rao
  • Jennifer M. Fal
  • Jonathan M. Chen
  • Jeffrey A. Morgan
  • Deon W. Vigilance
  • Mauricio J. Garrido
  • Carmelo A. Milano
  • Yoshifumi Naka

DOI:

https://doi.org/10.1532/HSF98.20061063

Abstract

Background. A risk factor summation score was previously validated to successfully predict survival after insertion of a left ventricular assist device (LVAD). We investigated whether this scoring system also predicts clinical outcomes after eventual heart transplantation in LVAD recipients.

Methods. A retrospective review was performed on 153 consecutive patients who received an LVAD as a bridge to transplantation at 2 large-volume centers from 1996 to 2003. The scoring system was used to designate low- and high-scoring groups.

Results. Thirty-day mortality and 5-year survival after transplantation were equivalent between groups (4.46% versus 7.32% and 76% versus 70%, respectively). No difference was seen in length of posttransplantation ventilator dependence (2.83 ± 0.49 versus 3.3 ± 0.72 days) or intensive care unit monitoring (6.38 ± 0.77 versus 6.97 ± 1.1 days). However, low-scoring patients had a significantly decreased duration of inotrope support (5.57 ± 0.45 versus 7.74 ± 1.0 days, P = .035).

Conclusion. A risk factor summation score may predict which LVAD patients will require prolonged inotropic support following heart transplantation. However, survival in high-risk (elevated score) LVAD patients following heart transplantation is comparable to low-risk groups, favoring the continued practice of LVAD implantation as a bridge to transplantation even in high-risk patients.

References

Aaronson KD, Eppinger MJ, Dyke DB, et al. 2002. Left ventricular assist device therapy improves utilization of donor hearts. J Am Coll Cardiol 39:1247-54.nBank AJ, Mir SH, Nguyen DQ, et al. 2000. Effects of left ventricular assist devices on outcomes in patients undergoing heart transplantation. Ann Thorac Surg 69:1369-74.nGammie JS, Edwards LB, Griffith BP, et al. 2004. Optimal timing of cardiac transplantation after ventricular assist device implantation. J Thorac Cardiovasc Surg 127:1789-99.nKherani AR, Maybaum S, Oz MC. 2004. Ventricular assist devices as a bridge to transplant or recovery. Cardiology 101:93-103.nOz MC, Goldstein DJ, Pepino P, et al. 1995. Screening scale predicts patients successfully receiving long-term implantable left ventricular assist devices. Circulation 92(9 suppl):II169-73.nPeterze B, Lonn U, Jansson K, et al. 2002. Long-term follow-up of patients treated with an implantable left ventricular assist device as an extended bridge to heart transplantation. J Heart Lung Transplant 21:604-7.nRao V, Oz MC, Flannery MA, et al. 2003. Revised screening scale to predict survival following left ventricular assist device insertion. J Thorac Cardiovasc Surg 125:855-62.nRose EA, Gelijns AC, Moskowitz AJ, et al. 2001. Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) Study Group. NEJM 345:1435-43.n

Published

2006-07-25

How to Cite

Lima, B., Kherani, A. R., Hata, J. A., Cheema, F. H., Casher, J., Oz, M. C., Rao, V., Fal, J. M., Chen, J. M., Morgan, J. A., Vigilance, D. W., Garrido, M. J., Milano, C. A., & Naka, Y. (2006). Does A Pre-Left Ventricular Assist Device Screening Score Predict Long-Term Transplantation Success? A 2-Center Analysis. The Heart Surgery Forum, 9(5), E783-E785. https://doi.org/10.1532/HSF98.20061063

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