Role of ventricular assist therapy for patients with heart failure and restrictive physiology: Improving outcomes for a lethal disease

Avishay Grupper, Soon J Park, Naveen L. Pereira, Sarah D. Schettle, Yariv Gerber, Yan Topilsky, Brooks S. Edwards, Richard C. Daly, John M. Stulak, Lyle D. Joyce, Sudhir S. Kushwaha

Research output: Contribution to journalArticlepeer-review

31 Scopus citations

Abstract

Background Restrictive cardiomyopathy (RCM) patients have poor prognosis due to progressive heart failure characterized by impaired ventricular filling of either or both ventricles. The goal of this study was to evaluate the outcome of end-stage RCM patients after left ventricular assist device (LVAD) implantation and to determine factors that may be associated with improved survival. Methods This investigation is a retrospective study of prospectively collected data that include 28 consecutive patients with end-stage RCM who received continuous-flow LVADs at the Mayo Clinic, Rochester, Minnesota. Outcome was assessed by survival with LVAD support until heart transplantation or all-cause mortality. Results The mean follow-up time post-LVAD implantation was 448 ± 425 days. The mean hospitalization time was 29 ± 19 days and was complicated mainly by post-operative right ventricular (RV) failure requiring short-term medical support. The short-term in-hospital mortality was 14%. Ten patients underwent heart transplantation with 100% survival post-transplant during the follow-up period. One-year survival for patients with LVADs without transplantation was 64%, and was not significantly different between amyloidosis and non-amyloidosis patients. Larger left ventricle (LV) end-diastolic and end-systolic dimensions were significantly associated with improved survival rates (RR = 0.94 and 0.95, p <0.05, respectively), and left ventricular end-diastolic diameter (LVEDD) ≤46 mm was associated with increased mortality post-LVAD implantation. Conclusions LVAD is a feasible, life-saving therapy for end-stage heart failure related to RCM, especially as a bridge to transplant and in patients with larger LV dimensions.

Original languageEnglish (US)
Article number5993
Pages (from-to)1042-1049
Number of pages8
JournalJournal of Heart and Lung Transplantation
Volume34
Issue number8
DOIs
StatePublished - Aug 1 2015

Keywords

  • outcome
  • restrictive cardiomyopathy
  • transplantation
  • ventricular assist device

ASJC Scopus subject areas

  • Transplantation
  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine
  • Surgery

Fingerprint Dive into the research topics of 'Role of ventricular assist therapy for patients with heart failure and restrictive physiology: Improving outcomes for a lethal disease'. Together they form a unique fingerprint.

Cite this