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Preoperative Predictors of Mortality in Short-Term Continuous-Flow Ventricular Assist Devices

Bozso, Sabin J.*; Buchholz, Holger*; Pidborochynski, Tara; Freed, Darren H.*,†; MacArthur, Roderick G.*; Conway, Jennifer

doi: 10.1097/MAT.0000000000000902
Original Article: PDF Only
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Short-term continuous-flow ventricular assist devices (STCF-VADs) are increasingly being utilized to support critically ill patients, despite limited information regarding overall outcomes. All adult patients supported with an STCF-VAD between June 2009 and December 2015 were included in this retrospective single-center study. Associations between preoperative characteristics and unsuccessful bridge (death on device or within 30 days postdecannulation) were assessed using logistic regression. A total of 61 patients (77% male) were identified with a median age at implant of 54.6 years. Left VADs were implanted in 51%, right VADs in 21%, and both VADs in 28%, and patients were supported for a median of 11 days. Overall, 23% were weaned to recovery, 13% underwent heart transplantation, 16% converted to long-term VADs, and 48% had an unsuccessful bridge. In multivariable analysis, only renal insufficiency or dialysis (odds ratio = 7.53; p = 0.002) remained a significant independent predictor of an unsuccessful bridge. Short-term continuous-flow VADs can successfully bridge adult patients with mortality around 50%. Preimplant renal insufficiency or dialysis is correlated with an unsuccessful bridge in our patient population, likely reflecting the severity of illness preimplant. Further studies are required to determine whether this factor remains significant in a larger patient population.

From the *Division of Cardiac Surgery, University of Alberta, Edmonton, Alberta, Canada

Division of Pediatric Cardiac Surgery, Stollery Children’s Hospital, Edmonton, Alberta, Canada

Division of Cardiology, Division of Pediatric Cardiology, University of Alberta, Edmonton, Alberta, Canada

Submitted for consideration April 2018; accepted for publication in revised form June 2018.

Disclosures: Holger Buchholz is a consultant for Abbott. None of the other authors have no conflicts of interest to report.

This research has been facilitated by the Women and Children’s Health Research Institute through the generosity of the Stollery Children’s Hospital Foundation and supporters of the Lois Hole Hospital for Women and the Health Outcomes Improvement (HOI) Fund from Maternal, Newborn, Child and Youth Strategic Clinical Network.

Correspondence: Jennifer Conway, Division of Cardiology, Division of Pediatric Cardiology, University of Alberta, 8440 112 St NW, Edmonton, AB T6G2B7, Canada. Email: jennifer.conway2@albertahealthservices.ca.

Copyright © 2019 by the American Society for Artificial Internal Organs