Preoperative renal dysfunction does not affect outcomes of left ventricular assist device implantation

The Journal of Thoracic and Cardiovascular Surgery
Arman KilicPavan Atluri

Abstract

Selection criteria for durable left ventricular assist device (LVAD) implantation remain unclear. One such criterion is renal function. In this study we evaluated outcomes of LVAD implantation in patients with preoperative renal dysfunction. Patients with implanted LVADs as destination therapy (DT) or bridge to transplantation (BTT) at a single institution between 2006 and 2015 were included. Primary stratification was according to pre-implantation glomerular filtration rate (GFR): >60 mL/min versus <60 mL/min or dialysis dependence. The primary outcome was post-LVAD implantation overall survival. Two hundred thirty-eight patients underwent LVAD implantation during the study period as DT (60%; n = 142) or BTT (40%; n = 96). Reduced GFR was present in 56% (n = 132), with 8% (n = 18) being dialysis-dependent. Normal versus reduced GFR cohorts were well matched except for a higher incidence of coronary artery disease in the patients with reduced GFR (61% vs 48%; P = .04). Mean follow-up was 13.5 ± 17.0 months. Unadjusted and risk-adjusted survival at 1, 3, 6, and 12 months after LVAD implantation were similar between the cohorts for DT and BTT. Rates of transplantation were comparable in BTT patients (61% normal vs 53% reduced GFR...Continue Reading

Citations

Mar 27, 2021·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Alexis K OkohLeonard Y Lee
Dec 26, 2021·Journal of Cardiac Surgery·Antonio Loforte
May 28, 2019·The Journal of Thoracic and Cardiovascular Surgery·Jason J Han, Pavan Atluri

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