Melding a High-Risk Patient for Continuous Flow Left Ventricular Assist Device into a Low-Risk Patient

ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Javier Amione-GuerraBarry H Trachtenberg

Abstract

The model for end-stage liver disease (MELD) has been used as a predictor of mortality after left ventricular assist device (LVAD) placement. However, improvement or worsening of MELD and how those changes affect outcomes is unknown. We performed a retrospective analysis of 244 patients implanted with a continuous flow (CF) LVAD. Patients were dichotomized at admission into low- or high-risk categories using a cutoff of MELD ≥ 19, and they were reclassified at day of implant forming four groups: Group LL (low to low, remained low risk), LH (low to high, worsened to high risk), HH (high to high, remained high risk), and HL (high to low, improved to low risk). Patients who improved to a low risk (group HL) had the same 1 year survival as those that remained low risk (group LL; 80% vs. 77%; p = 0.6). However, patients who were initially classified as low risk and worsened to a high risk (group LH) had a survival that was worse than those that were consistently high risk (group HH; 55% vs. 10%; p = 0.01). Model for end-stage liver disease reclassification after adjusting for commonly attributed risk factors remained an independent predictor for mortality, including patients classified as Interagency Registry for Mechanically Assist...Continue Reading

References

Mar 25, 2000·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·M MalinchocP C ter Borg
Jan 17, 2002·The New England Journal of Medicine·E A RoseUNKNOWN Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) Study Group
Jul 11, 2006·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·M RavaioliA D Pinna
Sep 1, 2007·The New England Journal of Medicine·Leslie W MillerUNKNOWN HeartMate II Clinical Investigators
Feb 6, 2010·The Journal of Thoracic and Cardiovascular Surgery·Robert L KormosUNKNOWN HeartMate II Clinical Investigators
Mar 31, 2012·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Jonathan A YangP Christian Schulze
Apr 7, 2012·The Annals of Thoracic Surgery·Pramod BondeRobert L Kormos
Dec 25, 2012·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Salil V DeoSoon J Park
Dec 26, 2012·Journal of the American College of Cardiology·Jennifer CowgerMark S Slaughter
May 27, 2014·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·James K KirklinJames B Young
Nov 2, 2015·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·James K KirklinJames B Young

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Citations

Aug 8, 2019·Current Treatment Options in Cardiovascular Medicine·Chonyang L Albert, Jerry D Estep
May 18, 2019·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Evgenij V PotapovFinn Gustafsson

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