Abstract 18051: Mechanical Circulatory Support and Pulmonary Hypertension - An Analysis of United Network of Organ Sharing Registry
Background: Severe pulmonary hypertension (PH) is a relative contra-indication for heart transplantation (HT) per International Society of Heart and Lung Transplantation guidelines. Limited data exists comparing different types of mechanical circulatory support devices (MCSDs) for post-HT survival across severity categories of PH.
Methods: We performed post-hoc analysis of 14,481 patients (age: 53.3± 12 years, 76% males, median follow-up - 4.2 years) undergoing HT after January 1st, 2000 from the United Network of Organ Sharing registry database. Patients were divided into following categories of PH: None (pulmonary vascular resistance (PVR) <2.5 WU or trans-pulmonary gradient (TPG) <13 mmHg), mild to moderate (PVR ≥2.5 WU and <5 WU or TPG≥ 13 mm Hg and <20 mm Hg) and severe (PVR ≥ 5.0 WU or TPG ≥ 20 mm Hg). We also categorized patients based on types of MCSDs as following: None (n=10,142), pulsatile flow (PF) left (n=709), continuous flow (CF) left (n=3,166), biventricular (BiV; n=347) and total artificial heart (TAH;n=117). Post-HT survival was assessed using multivariable Cox proportional hazard analysis across categories of PH and MCSDs.
Results: See Figure 1 and 2.
Conclusion: For patients without PH, CF left MCSDs offered significantly better post-HT survival compared to other categories of MCSDs; risk of post-transplant mortality among those with PH was comparable between CF left MCSDs and those undergoing direct HT or having PF left MCSDs.
Author Disclosures: S. Zalawadiya: None. U. Egolum: None. H. Ooi: None.
- © 2015 by American Heart Association, Inc.