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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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Relationship of preoperative right ventricular (RV) dysfunction to postoperative survival. Groups are divided into those greater than the median of right ventricular function score of 4, and those ≤4 [95% confidence interval (CI) ≤4: 1151–1405, >4: 552–900]. The vertical line indicates 1 year, and after that there is a clear separation of both groups, though not before. Censoring the survival before 1 year results in a significant difference between these groups after 1 year (odds ratio 10.8).
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EZU258F4: Relationship of preoperative right ventricular (RV) dysfunction to postoperative survival. Groups are divided into those greater than the median of right ventricular function score of 4, and those ≤4 [95% confidence interval (CI) ≤4: 1151–1405, >4: 552–900]. The vertical line indicates 1 year, and after that there is a clear separation of both groups, though not before. Censoring the survival before 1 year results in a significant difference between these groups after 1 year (odds ratio 10.8).

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)

Relationship of preoperative right ventricular (RV) dysfunction to postoperative survival. Groups are divided into those greater than the median of right ventricular function score of 4, and those ≤4 [95% confidence interval (CI) ≤4: 1151–1405, >4: 552–900]. The vertical line indicates 1 year, and after that there is a clear separation of both groups, though not before. Censoring the survival before 1 year results in a significant difference between these groups after 1 year (odds ratio 10.8).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

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

EZU258F4: Relationship of preoperative right ventricular (RV) dysfunction to postoperative survival. Groups are divided into those greater than the median of right ventricular function score of 4, and those ≤4 [95% confidence interval (CI) ≤4: 1151–1405, >4: 552–900]. The vertical line indicates 1 year, and after that there is a clear separation of both groups, though not before. Censoring the survival before 1 year results in a significant difference between these groups after 1 year (odds ratio 10.8).
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