ORIGINAL CLINICAL SCIENCEInternational experience using a durable, centrifugal-flow ventricular assist device for biventricular support
Section snippets
Methods
This retrospective, multicenter study sought to identify patients implanted with a HVAD BiVAD between 2009 and 2017 at 12 international centers. The use of the HVAD pump for right ventricular support is considered to be an off-label indication. Institutional ethics approval was obtained for the collation of anonymized data. Implantation of the HVAD pump for right heart support was either performed at the same time as the HVAD LVAD implantation, as a primary implant, or >24 hours post-HVAD LVAD
Results
A total of 93 patients were identified in this retrospective, multicenter study. Demographics are outlined in Table 1. The average age of this patient population was 47.4 ± 12.93 years (range: 18–75 years), with 75.3% being male. The majority of the patients were classified as either INTERMACS Profile 1 (34.5%) or Profile 2 (26.4%) at implantation. The etiologies of heart failure (HF) were idiopathic (47.8%), myocarditis (15.9%), and ischemic (14.5%). Within this patient population, 47.3% of
Discussion
Right ventricular failure after LVAD implantation is still relatively common in INTERMACS Profile 1 and 2 patients and is associated with higher morbidity and mortality. Despite the incidence of refractory right HF in this patient population, there continue to be limited therapeutic options available. When patients develop refractory right HF, they are typically treated with temporary extracorporeal support, extracorporeal displacement pumps, or a more durable device such as a TAH or BiVADs. In
Disclosure statement
A.R.S. is a consultant for Medtronic and Transmedics Inc. J.G. and M.O. are consultants for Medtronic and Abbott. C.S.H. is a consultant for Medtronic and has received honoraria from Abbott and Medtronic. D.Z. and J.D.S. are consultants for Medtronic and receive research grant support from Abbott. The remaining authors have no conflicts of interest to disclose.
The authors gratefully acknowledge the assistance of Vince Cannon, Alexandra Dedrick, and Kristie Wallace from Medtronic for support in
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