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Abstracts: ASAIO Cardiac Abstracts

IMPACT OF AGE ON SURVIVAL AFTER IMPLANTATION OF LEFT VENTRICULAR ASSIST DEVICE

Potapov, Evgenij V1; Pasic, Miralem1; Weng, Yuguo1; Jurmann, Michael1; Stein, Julia1; Hetzer, Roland1

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Background

Implantation of LVAD prevents death in critically ill patients. The impact of age on outcome may be crucial but is still not well defined. We evaluated impact of age on outcome after LVAD implantation.

Methods

Since June 1987 LVADs were implanted in 403 patients. Patients were divided into four age groups: 360 years old (n=116); between 40 and 60 years old (n=204); between 18 and 40 years old (n=117) and <18 years old (n=56). We compared early outcome (30-day survival or HTx or weaning from LVAD during first 30 days) and late outcome (HTx, weaning, support >6 months in patients with definitive therapy or continuing support in others) among groups.

Results

Age was not related to early outcome (area under the ROC curve 0.56, p=0.7). Negative late outcome was more likely in older patients (area under the ROC curve 0.66, p<0.001). The highest risk for negative late outcome was in the oldest group (OR 2.5), while the best late outcome was observed in children (OR 0.5). In all patients emergency LVAD implantation was a risk factor for early (OR 1.9) but not for late outcome (OR 1.1), while postcardiotomy surgery was a risk factor for both outcomes (OR’s 5.6 and 2.0, resp.). Emergency implantation negatively influenced late outcome (OR 2.2) in older patients only. Gender and ischemic heart disease did not influence either outcome.

Conclusion

Advanced age does not affect early outcome but is a significant risk factor for late outcome after LVAD implantation. In patients over 60 years old the decision for LVAD implantation should be made as early as possible.

Copyright © 2005 by the American Society for Artificial Internal Organs