Abstract
The optimal advanced heart failure (HF) therapy strategy for patients aged 60 or older with end-stage HF refractory to optimal medical therapy remains uncertain. This study compares outcomes of three advanced HF therapy strategies in this patient population. A single-center retrospective study was conducted in 95 patients aged 60-73 years who had undergone isolated heart transplantation (HTx) or continuous flow left ventricular assist device (LVAD) implantation from 2010 to 2017. Patients were stratified into three cohorts by strategy; HTx-only (N.=25), LVAD-to-HTx (N.=29), and LVAD-only (N.=41). Primary end point was 2-year overall survival. Secondary end points included incidence of post-operative adverse events, freedom from first readmission at 1 year, and percentage of days spent in hospital following advanced HF therapy. Two-year survival was 91% in HTx-only patients, 88% in LVAD-to-HTx patients, and 49% in LVAD-only patients (P=0.0008). No significant difference in post-transplant survival was found between patients with or without LVAD-related adverse events preceding transplantation (P=0.42). One-year freedom from first readmission was 38.3% in HTx-only patients, 17.2% in LVAD-to-HTx patients and 7.3% in LVAD-only pati...Continue Reading
References
Jul 28, 2011·Congestive Heart Failure·Omar F Abouezzeddine, Margaret M Redfield
Apr 30, 2014·The Annals of Thoracic Surgery·Bryan A WhitsonRanjit John
May 14, 2014·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·William G CottsKathleen L Grady
Sep 4, 2014·Current Heart Failure Reports·Shannon M Dunlay, Véronique L Roger
Nov 30, 2014·Journal of Cardiac Failure·Snehal R PatelDaniel Goldstein
Dec 17, 2014·The Annals of Thoracic Surgery·Robert A SorabellaYoshifumi Naka
Jan 1, 2015·Anatolian Journal of Cardiology·Ibadete Bytyçi, Gani Bajraktari
May 20, 2015·International Journal of Cardiology·Markku S NieminenRobert Zymliński
Jun 21, 2015·The American Journal of Cardiology·Mani A DaneshmandChetan B Patel
Feb 21, 2016·The Journal of Thoracic and Cardiovascular Surgery·Shinichi FukuharaYoshifumi Naka
Feb 26, 2016·Clinical Transplantation·Silvana F MarascoMarco Luthe
Jul 3, 2016·Heart Failure Clinics·Sunit-Preet Chaudhry, Garrick C Stewart
Oct 25, 2016·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Lars H LundUNKNOWN International Society for Heart and Lung Transplantation
Jan 27, 2017·Circulation·Emelia J BenjaminUNKNOWN American Heart Association Statistics Committee and Stroke Statistics Subcommittee
Feb 9, 2017·The Annals of Thoracic Surgery·Daisuke YoshiokaKoji Takeda
Jun 13, 2017·Heart Failure Clinics·Chris CaraangChhaya Aggarwal Gupta
Jun 28, 2017·The Annals of Thoracic Surgery·Robert J SteffenNader Moazami
Aug 7, 2017·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Lars H LundUNKNOWN International Society for Heart and Lung Transplantation
Sep 25, 2017·The Annals of Thoracic Surgery·Dhaval ChauhanMark J Russo
Sep 25, 2017·Journal of the American Geriatrics Society·Mathew S MaurerGordon R Reeves
Sep 26, 2017·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·James K KirklinDavid C Naftel
Dec 14, 2017·Expert Review of Cardiovascular Therapy·Nandini Nair, Enrique Gongora