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Four-year outcomes with third-generation centrifugal left ventricular assist devices in an era of restricted transplantation.

Özalp F, Bhagra S, Bhagra C, Butt T, Ramesh B, Robinson-Smith N, Wrightson N, Parry G, Griselli M, Hasan A, Schueler S, MacGowan GA - Eur J Cardiothorac Surg (2014)

Bottom Line: Older age and more acute INTERMACS groups were significantly related to reduced survival within the first 90 days (P = 0.030 and 0.010, respectively).Poor preoperative right ventricular (RV) function had a negative effect on survival after 1 year (P = 0.009), though not earlier.Only 14 of 102 patients were transplanted at a median of 334 ± 347 days, and only 3 were transplanted within the first 6 months.

View Article: PubMed Central - PubMed

Affiliation: Departments of Cardiothoracic Surgery and Cardiopulmonary Transplantation, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.

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Survival on device of patients grouped into INTERMACS classes 1–4. Overall survival (A) [95% confidence interval (CI): INTERMACS 1: 42–616, INTERMACS 2: 848–1424, INTERMACS 3: 744–1168, INTERMACS 4: 764–1204], early (up to 90 days, B) (95% CI: INTERMACS 1–4: 29–101, 72–88, 88–91, 78–91) and late (after 90 days with deaths before 90 days censored, C) (95% CI: INTERMACS 1–4: 578–1016, 1011–1532, 765–1233, 885–1277).
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EZU258F3: Survival on device of patients grouped into INTERMACS classes 1–4. Overall survival (A) [95% confidence interval (CI): INTERMACS 1: 42–616, INTERMACS 2: 848–1424, INTERMACS 3: 744–1168, INTERMACS 4: 764–1204], early (up to 90 days, B) (95% CI: INTERMACS 1–4: 29–101, 72–88, 88–91, 78–91) and late (after 90 days with deaths before 90 days censored, C) (95% CI: INTERMACS 1–4: 578–1016, 1011–1532, 765–1233, 885–1277).

Mentions: Age significantly predicted early outcomes (defined as survival on device, Fig. 2). This included the overall follow-up time (P = 0.046, Fig. 2A), but the effect was primarily related to the first 90 days (all patients were discharged home within 90 days) (P = 0.030, Fig. 2B), and not in those that survived the first 90 days (deaths prior to 90 days censored, P = 0.51, Fig. 2C). A similar phenomenon was seen with the INTERMACS classification, in that more acute INTERMACS classes predicted outcomes (P = 0.046, Fig. 3A), 90-day outcomes (P = 0.010, Fig. 3B), but not outcomes in those that survived 90 days (P = 0.74, Fig. 3C). LV end-diastolic and end-systolic diameters and RV size had no significant effect on overall survival (all P = NS, data not shown). Poor preoperative RV function had a significant effect on survival in those who survived past 1 year (P = 0.009), though not earlier (Fig. 4). RV size had a borderline effect on survival in those who survived past 1 year (P = 0.067, data not shown). No significant effect on outcome was seen with gender, aetiology of heart failure or year of implant (all P = NS, data not shown).Figure 2:


Four-year outcomes with third-generation centrifugal left ventricular assist devices in an era of restricted transplantation.

Özalp F, Bhagra S, Bhagra C, Butt T, Ramesh B, Robinson-Smith N, Wrightson N, Parry G, Griselli M, Hasan A, Schueler S, MacGowan GA - Eur J Cardiothorac Surg (2014)

Survival on device of patients grouped into INTERMACS classes 1–4. Overall survival (A) [95% confidence interval (CI): INTERMACS 1: 42–616, INTERMACS 2: 848–1424, INTERMACS 3: 744–1168, INTERMACS 4: 764–1204], early (up to 90 days, B) (95% CI: INTERMACS 1–4: 29–101, 72–88, 88–91, 78–91) and late (after 90 days with deaths before 90 days censored, C) (95% CI: INTERMACS 1–4: 578–1016, 1011–1532, 765–1233, 885–1277).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC4128784&req=5

EZU258F3: Survival on device of patients grouped into INTERMACS classes 1–4. Overall survival (A) [95% confidence interval (CI): INTERMACS 1: 42–616, INTERMACS 2: 848–1424, INTERMACS 3: 744–1168, INTERMACS 4: 764–1204], early (up to 90 days, B) (95% CI: INTERMACS 1–4: 29–101, 72–88, 88–91, 78–91) and late (after 90 days with deaths before 90 days censored, C) (95% CI: INTERMACS 1–4: 578–1016, 1011–1532, 765–1233, 885–1277).
Mentions: Age significantly predicted early outcomes (defined as survival on device, Fig. 2). This included the overall follow-up time (P = 0.046, Fig. 2A), but the effect was primarily related to the first 90 days (all patients were discharged home within 90 days) (P = 0.030, Fig. 2B), and not in those that survived the first 90 days (deaths prior to 90 days censored, P = 0.51, Fig. 2C). A similar phenomenon was seen with the INTERMACS classification, in that more acute INTERMACS classes predicted outcomes (P = 0.046, Fig. 3A), 90-day outcomes (P = 0.010, Fig. 3B), but not outcomes in those that survived 90 days (P = 0.74, Fig. 3C). LV end-diastolic and end-systolic diameters and RV size had no significant effect on overall survival (all P = NS, data not shown). Poor preoperative RV function had a significant effect on survival in those who survived past 1 year (P = 0.009), though not earlier (Fig. 4). RV size had a borderline effect on survival in those who survived past 1 year (P = 0.067, data not shown). No significant effect on outcome was seen with gender, aetiology of heart failure or year of implant (all P = NS, data not shown).Figure 2:

Bottom Line: Older age and more acute INTERMACS groups were significantly related to reduced survival within the first 90 days (P = 0.030 and 0.010, respectively).Poor preoperative right ventricular (RV) function had a negative effect on survival after 1 year (P = 0.009), though not earlier.Only 14 of 102 patients were transplanted at a median of 334 ± 347 days, and only 3 were transplanted within the first 6 months.

View Article: PubMed Central - PubMed

Affiliation: Departments of Cardiothoracic Surgery and Cardiopulmonary Transplantation, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.

Show MeSH
Related in: MedlinePlus