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Early and mid-term outcomes of left ventricular assist device implantation and future prospects

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An Editorial to this article was published on 19 August 2015

Abstract

Objectives

Although implantable left ventricular assist device use as a bridge to heart transplantation is increasing, its permanent use as destination therapy is not permitted in Japan. This retrospective review assessed early and mid-term outcomes of implantable continuous-flow left ventricular assist device compared with extracorporeal pulsatile-flow left ventricular assist device implantation. Issues regarding left ventricular assist device as destination therapy are discussed.

Methods

From January 2009 to September 2013, 72 patients underwent left ventricular assist device implantation at our institute. Forty patients were supported by extracorporeal pulsatile-flow left ventricular assist devices (ex-VAD group) and 32 patients with implantable continuous-flow left ventricular assist devices (im-VAD group).

Results

The median duration of ventricular assist device support was 563 days. The actuarial survival rates at 1 and 3 years were 92.3 and 79.2 % in the ex-VAD group and 96.4 and 72.3 % in the im-VAD group, respectively. Approximately 50 % of patients in both groups developed cerebrovascular complications within 1 year postoperatively. Six months post-implantation, almost 90 % of the ex-VAD group patients suffered exit-site infection compared with about 50 % in the im-VAD group. Readmission rate was 1.74 per patient-year; major causes were driveline exit-site infection (52 %) and cerebrovascular complication (14 %).

Conclusions

Early and mid-term outcomes were satisfactory after both extracorporeal pulsatile-flow left ventricular assist device and implantable continuous-flow left ventricular assist device implantation, although a considerable level of postoperative complications was observed. More data after left ventricular assist device surgery are needed to enable its consideration as a destination therapy option in Japan.

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Conflict of interest

The authors have declared that no conflict of interest exists.

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan

    Hiroki Hata, Tomoyuki Fujita, Yusuke Shimahara, Shunsuke Sato & Junjiro Kobayashi

  2. Department of Transplantation, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan

    Masanobu Yanase, Osamu Seguchi, Takuma Sato & Takeshi Nakatani

Authors
  1. Hiroki Hata
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  2. Tomoyuki Fujita
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  3. Yusuke Shimahara
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  4. Shunsuke Sato
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  5. Masanobu Yanase
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  6. Osamu Seguchi
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  7. Takuma Sato
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  8. Takeshi Nakatani
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  9. Junjiro Kobayashi
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Corresponding author

Correspondence to Hiroki Hata.

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Hata, H., Fujita, T., Shimahara, Y. et al. Early and mid-term outcomes of left ventricular assist device implantation and future prospects. Gen Thorac Cardiovasc Surg 63, 557–564 (2015). https://doi.org/10.1007/s11748-015-0538-7

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  • DOI: https://doi.org/10.1007/s11748-015-0538-7

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