Temporal differences in causes of mortality after left ventricular assist device implantation

John M. Stulak, Vivek Mehta, John A. Schirger, Keith D. Aaronson, Lyle D. Joyce, Richard C. Daly, Francis D. Pagani, Simon Maltais

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background The risk of device-related adverse events leading to death is abundant and ever-present after left ventricular assist device (VAD) implantation. Very few data specifically examine the causes of death related to length of time after VAD implantation. Methods Between October 2004 and February 2013, 493 patients (395 male, 80%) underwent primary continuous-flow VAD implantation at our institutions. The median age at implantation was 60 years (range, 18-79 years), and 301 patients (62%) underwent bridge to transplantation. Results Follow-up was available for all patients (median, 13 months) for a total of 717 patient-years of support. There were 132 deaths during follow-up (median, 8 months; early, 5.5 years) after VAD implantation. The patients were grouped according to temporal occurrence of deaths: (1) early (30-day or index hospitalization) in 34 of 132 patients (26%), (2) between hospital dismissal and 6 months in 29 of 132 patients (22%), (3) 6 months to 1 year in 14 of 132 patients (11%), and (4) after 1 year in 55 of 132 patients (42%). The causes of death (%) at each time period are presented; the most common early cause was right ventricular failure/multisystem organ failure in 18 of 34 patients (61%); from dismissal to 6 months, and 6 months to 1 year, cerebral hemorrhage in 6 of 29 patients (21%) and 4 of 14 patients (29%), respectively; after 1 year, cerebral hemorrhage in 12 of 55 patients (22%) and right ventricular failure/multisystem organ failure in 11 of 55 patients (20%). Conclusions The causes of death vary according to time after VAD implantation. Understanding the temporal relationship of causes of mortality after VAD implantation is critical to the identification of varying specific risks in an effort to avoid morbidity, which may ultimately detract from a durable VAD outcome.

Original languageEnglish (US)
Pages (from-to)1969-1974
Number of pages6
JournalAnnals of Thoracic Surgery
Volume99
Issue number6
DOIs
StatePublished - Jun 1 2015

Fingerprint

Heart-Assist Devices
Mortality
Cause of Death
Cerebral Hemorrhage
Patient Rights
Hospitalization

ASJC Scopus subject areas

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

Cite this

Temporal differences in causes of mortality after left ventricular assist device implantation. / Stulak, John M.; Mehta, Vivek; Schirger, John A.; Aaronson, Keith D.; Joyce, Lyle D.; Daly, Richard C.; Pagani, Francis D.; Maltais, Simon.

In: Annals of Thoracic Surgery, Vol. 99, No. 6, 01.06.2015, p. 1969-1974.

Research output: Contribution to journalArticle

Stulak, JM, Mehta, V, Schirger, JA, Aaronson, KD, Joyce, LD, Daly, RC, Pagani, FD & Maltais, S 2015, 'Temporal differences in causes of mortality after left ventricular assist device implantation', Annals of Thoracic Surgery, vol. 99, no. 6, pp. 1969-1974. https://doi.org/10.1016/j.athoracsur.2015.01.036
Stulak, John M. ; Mehta, Vivek ; Schirger, John A. ; Aaronson, Keith D. ; Joyce, Lyle D. ; Daly, Richard C. ; Pagani, Francis D. ; Maltais, Simon. / Temporal differences in causes of mortality after left ventricular assist device implantation. In: Annals of Thoracic Surgery. 2015 ; Vol. 99, No. 6. pp. 1969-1974.
@article{b623c25c141443d79bf7610af064b428,
title = "Temporal differences in causes of mortality after left ventricular assist device implantation",
abstract = "Background The risk of device-related adverse events leading to death is abundant and ever-present after left ventricular assist device (VAD) implantation. Very few data specifically examine the causes of death related to length of time after VAD implantation. Methods Between October 2004 and February 2013, 493 patients (395 male, 80{\%}) underwent primary continuous-flow VAD implantation at our institutions. The median age at implantation was 60 years (range, 18-79 years), and 301 patients (62{\%}) underwent bridge to transplantation. Results Follow-up was available for all patients (median, 13 months) for a total of 717 patient-years of support. There were 132 deaths during follow-up (median, 8 months; early, 5.5 years) after VAD implantation. The patients were grouped according to temporal occurrence of deaths: (1) early (30-day or index hospitalization) in 34 of 132 patients (26{\%}), (2) between hospital dismissal and 6 months in 29 of 132 patients (22{\%}), (3) 6 months to 1 year in 14 of 132 patients (11{\%}), and (4) after 1 year in 55 of 132 patients (42{\%}). The causes of death ({\%}) at each time period are presented; the most common early cause was right ventricular failure/multisystem organ failure in 18 of 34 patients (61{\%}); from dismissal to 6 months, and 6 months to 1 year, cerebral hemorrhage in 6 of 29 patients (21{\%}) and 4 of 14 patients (29{\%}), respectively; after 1 year, cerebral hemorrhage in 12 of 55 patients (22{\%}) and right ventricular failure/multisystem organ failure in 11 of 55 patients (20{\%}). Conclusions The causes of death vary according to time after VAD implantation. Understanding the temporal relationship of causes of mortality after VAD implantation is critical to the identification of varying specific risks in an effort to avoid morbidity, which may ultimately detract from a durable VAD outcome.",
author = "Stulak, {John M.} and Vivek Mehta and Schirger, {John A.} and Aaronson, {Keith D.} and Joyce, {Lyle D.} and Daly, {Richard C.} and Pagani, {Francis D.} and Simon Maltais",
year = "2015",
month = "6",
day = "1",
doi = "10.1016/j.athoracsur.2015.01.036",
language = "English (US)",
volume = "99",
pages = "1969--1974",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "6",

}

TY - JOUR

T1 - Temporal differences in causes of mortality after left ventricular assist device implantation

AU - Stulak, John M.

AU - Mehta, Vivek

AU - Schirger, John A.

AU - Aaronson, Keith D.

AU - Joyce, Lyle D.

AU - Daly, Richard C.

AU - Pagani, Francis D.

AU - Maltais, Simon

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Background The risk of device-related adverse events leading to death is abundant and ever-present after left ventricular assist device (VAD) implantation. Very few data specifically examine the causes of death related to length of time after VAD implantation. Methods Between October 2004 and February 2013, 493 patients (395 male, 80%) underwent primary continuous-flow VAD implantation at our institutions. The median age at implantation was 60 years (range, 18-79 years), and 301 patients (62%) underwent bridge to transplantation. Results Follow-up was available for all patients (median, 13 months) for a total of 717 patient-years of support. There were 132 deaths during follow-up (median, 8 months; early, 5.5 years) after VAD implantation. The patients were grouped according to temporal occurrence of deaths: (1) early (30-day or index hospitalization) in 34 of 132 patients (26%), (2) between hospital dismissal and 6 months in 29 of 132 patients (22%), (3) 6 months to 1 year in 14 of 132 patients (11%), and (4) after 1 year in 55 of 132 patients (42%). The causes of death (%) at each time period are presented; the most common early cause was right ventricular failure/multisystem organ failure in 18 of 34 patients (61%); from dismissal to 6 months, and 6 months to 1 year, cerebral hemorrhage in 6 of 29 patients (21%) and 4 of 14 patients (29%), respectively; after 1 year, cerebral hemorrhage in 12 of 55 patients (22%) and right ventricular failure/multisystem organ failure in 11 of 55 patients (20%). Conclusions The causes of death vary according to time after VAD implantation. Understanding the temporal relationship of causes of mortality after VAD implantation is critical to the identification of varying specific risks in an effort to avoid morbidity, which may ultimately detract from a durable VAD outcome.

AB - Background The risk of device-related adverse events leading to death is abundant and ever-present after left ventricular assist device (VAD) implantation. Very few data specifically examine the causes of death related to length of time after VAD implantation. Methods Between October 2004 and February 2013, 493 patients (395 male, 80%) underwent primary continuous-flow VAD implantation at our institutions. The median age at implantation was 60 years (range, 18-79 years), and 301 patients (62%) underwent bridge to transplantation. Results Follow-up was available for all patients (median, 13 months) for a total of 717 patient-years of support. There were 132 deaths during follow-up (median, 8 months; early, 5.5 years) after VAD implantation. The patients were grouped according to temporal occurrence of deaths: (1) early (30-day or index hospitalization) in 34 of 132 patients (26%), (2) between hospital dismissal and 6 months in 29 of 132 patients (22%), (3) 6 months to 1 year in 14 of 132 patients (11%), and (4) after 1 year in 55 of 132 patients (42%). The causes of death (%) at each time period are presented; the most common early cause was right ventricular failure/multisystem organ failure in 18 of 34 patients (61%); from dismissal to 6 months, and 6 months to 1 year, cerebral hemorrhage in 6 of 29 patients (21%) and 4 of 14 patients (29%), respectively; after 1 year, cerebral hemorrhage in 12 of 55 patients (22%) and right ventricular failure/multisystem organ failure in 11 of 55 patients (20%). Conclusions The causes of death vary according to time after VAD implantation. Understanding the temporal relationship of causes of mortality after VAD implantation is critical to the identification of varying specific risks in an effort to avoid morbidity, which may ultimately detract from a durable VAD outcome.

UR - http://www.scopus.com/inward/record.url?scp=84930931733&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84930931733&partnerID=8YFLogxK

U2 - 10.1016/j.athoracsur.2015.01.036

DO - 10.1016/j.athoracsur.2015.01.036

M3 - Article

C2 - 25865761

AN - SCOPUS:84930931733

VL - 99

SP - 1969

EP - 1974

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 6

ER -