Acute kidney injury after implantation of a left ventricular assist device: a comparison of axial-flow (HeartMate II) and centrifugal-flow (HeartWare HVAD) devices

Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs
Azeen AnjumJeffrey A Morgan

Abstract

Continuous-flow left ventricular assist devices (CF-LVADs) are increasingly being used to treat advanced, refractory chronic heart failure. Herein, we sought to determine the incidence of postoperative acute kidney injury (AKI) in axial-flow (HeartMate II; HM-II) and centrifugal-flow (HVAD) CF-LVAD recipients, as well as the effect of AKI on mortality. The study cohort comprised 520 patients who received a HM-II (n = 398) or HVAD (n = 122) at our center between November 2003 and March 2016. Their records were reviewed to determine the incidence of RIFLE-defined AKI after LVAD implantation. We compared the perioperative characteristics, postoperative complications, and survival rates of the patients with and without AKI and differentiated the outcomes based on device type (HM-II or HVAD). Seventy-five patients (14.4%) developed AKI postoperatively. Patients with AKI after LVAD implantation had significantly reduced survival compared to patients without AKI (p = 0.01). Cox proportional hazards models showed that AKI was a significant independent predictor of mortality (HR = 1.54, p = 0.03). Preoperative mechanical circulatory support and prolonged cardiopulmonary bypass time were independent predictors of AKI. The incidence of AK...Continue Reading

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Citations

Feb 24, 2019·Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs·Y SawaT Yamaoka
Feb 19, 2021·Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs·Umang ParikhSubhasis Chatterjee
Aug 5, 2021·European Journal of Clinical Investigation·Alessia GambaroFlavio Luciano Ribichini

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