Abstract 17408: Left Ventricle Internal Dimension in Diastole Strongly Predicts Long-term Survival Following Continuous Flow Left Ventricular Assist Device Implantation
Introduction: Left ventricular assist devices (LVADs) are seldom implanted in small hearts, determined by left ventricle internal diameter in diastole (LVIDD), to avoid suction events thought to impact flows, arrhythmias and LVAD function. No published evidence has confirmed this theory.
Hypothesis: We aimed to determine if LVIDD impacts outcomes following LVAD insertion.
Methods: A single center, retrospective review was performed of all patients (N=449) implanted with a continuous flow (CF) LVAD between 12/1999-12/2013. Demographics, preoperative and operative data, perioperative outcomes, echocardiographic and right heart catheterization data, and late survival were determined. Univariate and survival analyses were performed. Multivariable regression identified independent predictors of survival.
Results: Patient characteristics, baseline echocardiographic and hemodynamic data, operative characteristics and clinical outcomes are summarized in Table 1. Patients with smaller LVIDD were more likely female, smaller BMI, and not bridge-to-transplant. Mean follow-up was 2.1 +/- 2.4 years (maximum 13.3 years). Early and late survival was worse in the smaller LVIDD patients (Figure 1). Multivariable regression analysis identified smaller LVIDD as a significant, independent risk factor for death (OR 1.4, 95% CI 1.1-1.8, p=0.01).
Conclusions: This is the largest experience of contemporary CF LVADs, along with long term survival data, at a single center. It is the first to clearly demonstrate that small LV cavity size is a significant predictor of poor long-term survival following LVAD implantation, in both unadjusted and adjusted analyses.
Author Disclosures: S.K. Singh: None. R.M. Shah: None. R.W. Fairchild: None. J. Anand: None. R. Hernandez: None. E. Sandoval: None. A.C. Baldwin: None. L. Simpson: None. A. Civitello: None. W.E. Cohn: None. O.H. Frazier: None. H.R. Mallidi: None.
- © 2014 by American Heart Association, Inc.