Abstract 4372: Tandem Heart® Percutaneous Ventricular Assist Device for Treatment of Cardiogenic Shock in Ischemic Versus Nonischemic Cardiomyopathy: A Single-Center Experience
Background Despite advancements in mechanical support for heart failure, cardiogenic shock (CS) carries substantial mortality risk. To add, determinants of benefit from percutaneous ventricular assist devices (pVAD) are unknown.
Methods Consecutive patients who underwent Tandem Heart® pVAD placement for CS were prospectively followed for the occurrence of in-hospital cardiovascular events. Baseline demographic and echocardiographic data were recorded. The primary outcome was in-hospital all-cause mortality.
Results Among the 35 patients included in this study, 8 (23%) had nonischemic cardiomyopathy (NICM) and 27 (77%) had ischemic cardiomyopathy (ICM). When compared to ICM, patients with NICM were younger (58±13 yrs vs. 39±17 yrs; p=0.03) and less likely to have hypertension (p=0.012) and dyslipidemia (p<0.0001). In addition, lower baseline ejection fraction (EF) (16±4% vs. 23 ±9%; p=0.007), with higher left ventricular end diastolic dimensions (6.8±1.3 cm vs. 5.6±0.8 cm p=0.018) and longer length of stay (92±81 days vs. 29±26 days p=0.001) were reported with NICM. Duration of pVAD support (5.2±2.7 days vs. 6.0±5.6 days p=0.586) and frequency of surgical VAD or transplant (37.5% vs. 18.5% p=0.261) were not different between the two groups. Despite having a lower EF, patients with NICM had improved prognosis compared to patients with ICM (in-hospital death 12.5% vs. 63% p=0.012) (Figure⇓).
Conclusions In this single-center experience, patients with NICM undergoing pVAD support for CS showed improved survival compared to patients with ICM despite worse left ventricular function.