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      Thirty-Day Readmissions After Left Ventricular Assist Device Implantation in the United States : Insights From the Nationwide Readmissions Database

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          Abstract

          Early readmissions contribute significantly to heart failure-related morbidity and negatively affect quality of life. Data on left ventricular assist device (LVAD)-related 30-day readmissions are scarce and limited to small studies.

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          Most cited references27

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          The 2013 International Society for Heart and Lung Transplantation Guidelines for mechanical circulatory support: executive summary.

          David Feldman, Salpy Pamboukian, Jeffrey Teuteberg … (2013)
          Article 0 comments Cited 237 times – based on 0 reviews     Review now
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            Extended mechanical circulatory support with a continuous-flow rotary left ventricular assist device.

            Francis Pagani, Leslie W Miller, Stuart D. Russell … (2009)
            This study sought to evaluate the use of a continuous-flow rotary left ventricular assist device (LVAD) as a bridge to heart transplantation. LVAD therapy is an established treatment modality for patients with advanced heart failure. Pulsatile LVADs have limitations in design precluding their use for extended support. Continuous-flow rotary LVADs represent an innovative design with potential for small size and greater reliability by simplification of the pumping mechanism. In a prospective, multicenter study, 281 patients urgently listed (United Network of Organ Sharing status 1A or 1B) for heart transplantation underwent implantation of a continuous-flow LVAD. Survival and transplantation rates were assessed at 18 months. Patients were assessed for adverse events throughout the study and for quality of life, functional status, and organ function for 6 months. Of 281 patients, 222 (79%) underwent transplantation, LVAD removal for cardiac recovery, or had ongoing LVAD support at 18-month follow-up. Actuarial survival on support was 72% (95% confidence interval: 65% to 79%) at 18 months. At 6 months, there were significant improvements in functional status and 6-min walk test (from 0% to 83% of patients in New York Heart Association functional class I or II and from 13% to 89% of patients completing a 6-min walk test) and in quality of life (mean values improved 41% with Minnesota Living With Heart Failure and 75% with Kansas City Cardiomyopathy questionnaires). Major adverse events included bleeding, stroke, right heart failure, and percutaneous lead infection. Pump thrombosis occurred in 4 patients. A continuous-flow LVAD provides effective hemodynamic support for at least 18 months in patients awaiting transplantation, with improved functional status and quality of life. (Thoratec HeartMate II Left Ventricular Assist System [LVAS] for Bridge to Cardiac Transplantation; NCT00121472).
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              Sixth INTERMACS annual report: a 10,000-patient database.

              D C Naftel, Amy Miller, James K Kirklin … (2014)
              The sixth annual report of the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) summarizes the first 8 years of patient enrollment. The analysis is based on data from >10,000 patients and updates demographics, survival, adverse events and risk factors. Among patients with continuous-flow pumps, actuarial survival continues to be 80% at 1 year and 70% at 2 years. The report features a comparison of two eras of continuous-flow durable devices in the USA in terms of device strategy, patient profiles, adverse event burden, survival and quality of life. Copyright © 2014 International Society for Heart and Lung Transplantation. All rights reserved.
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                Author and article information

                Journal
                Title: Circulation: Heart Failure
                Abbreviated Title: Circ Heart Fail
                Publisher: Ovid Technologies (Wolters Kluwer Health)
                ISSN (Print): 1941-3289
                ISSN (Electronic): 1941-3297
                Publication date Created: March 2018
                Publication date (Print): March 2018
                Volume: 11
                Issue: 3
                Affiliations
                [1 ]From the Division of Cardiology, St. Luke’s University Health Network, Bethlehem, PA (S.A.); Division of Cardiology, Lehigh Valley Health Network, Allentown, PA (L.G., M.S., B.P.); Department of Internal Medicine, University of Tennessee Health Science Center, Memphis (M.A.); Division of Non-Invasive Cardiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA (A.S.); Division of Cardiology, Newark Beth Israel Medical Center, NJ (A.G.); Division of Cardiology, Montefiore-Einstein...
                Article
                DOI: 10.1161/CIRCHEARTFAILURE.117.004628
                PubMed ID: 29519902
                SO-VID: 3f8eb737-a1f3-4255-9511-972c6224156e
                Copyright © © 2018
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