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DOI: 10.1055/s-0035-1544489
Institutional Experience with the HeartWare Ventricular Assist System in 100 Patients
Background: The implantation of a left ventricular assist device has become a standard treatment option for terminal heart failure. We present our institutional experience with the HeartWare Ventricular Assist System (HVAD) in 100 patients.
Methods: We retrospectively reviewed data of 100 patients receiving an HVAD between March 2006 and August 2013, regarding patient demographics, incidence of adverse events, length of support and outcomes, such as mortality or successful bridging.
Results: Mean age was 55 ± 13 years, ranging from 13 to 75 years. 82% of the patients were male, 43% suffered from ischemic cardiomyopathy. At the time of implantation, 30% of the patients were in INTERMACS level 1, 12% in INTERMACS level 2, 26% in INTERMACS level 3 and 26% in level 4–7. Duration of support ranged from 1 to 1935 days with a mean of 523 ± 375 days (Median 487 days). 37 patients (37%) were successfully bridged to transplantation, explant for recovery occurred in one patient (1%), 30 died on LVAD support (30%) and 32 remain still on the device (32%). 28 patients (28%) experienced at least one major bleeding event, including surgical bleedings in 43%, gastrointestinal bleedings in 33%, and intracranial bleedings in 24%. One or more thromboembolic complications occurred in 18 patients (18%) (50% pump thrombus, 50% ischemic strokes) and right heart failure in seven patients (7%). 13% of the adverse events had fatal consequences. 30-day and in-hospital mortality were low with 8% and 14%, respectively. One-year survival was 79%.
Conclusion: In our patient cohort, the HVAD has been demonstrated to efficiently support patients in terminal heart failure, providing excellent clinical outcomes.