Long-term follow-up of continuous flow left ventricular assist devices: complications and predisposing risk factors.

Published

Journal Article

To assess LVAD complications and their overall effect on mortality and determine factors associated with development of early and long-term complications.A retrospective cohort study of patients who underwent continuous flow LVAD placement between January 1, 2000 and November 30, 2013 was performed. The incidence of complications (sepsis or bacteremia, driveline infections, gastrointestinal bleeding, pump thrombosis, cerebrovascular accidents and anemia requiring transfusion) was collected and logistic regression and Cox proportional hazards analyses were performed.108 patients met our inclusion criteria. Median length of follow-up was 2.2 years. In univariable logistic regression analysis, higher blood urea nitrogen (BUN), creatinine clearance <60, no prior inotrope use, higher INTERMACS class and lower platelet count were associated with early complications. On multivariable analysis, factors associated with early complications included higher BUN (odds ratio (OR) 1.03, 95% confidence interval (CI) 1.001-1.06 per mg/dL BUN), no prior inotrope use (OR 4.92, 95% CI 1.64- 14.7) and lower platelet count (OR 4.29, 95% CI 1.45-12.7 <200 10(3) cu mm); 24% of patients developed early complications and 18.5% developed an early and late complication. Early complications were significantly associated with death (p = 0.017). The presence of 2 or more complications was associated with a 2.7-fold increase in the odds of death (p = 0.016) and odds of death increased by 20% with each subsequent complication (p = 0.004).LVADs are associated with significant long-term complications including stroke and sepsis and minimizing time on LVADs may decrease the risk of complications and subsequent morbidity and mortality.

Full Text

Duke Authors

Cited Authors

  • Adesiyun, TA; McLean, RC; Tedford, RJ; Whitman, GJR; Sciortino, CM; Conte, JV; Shah, AS; Russell, SD

Published Date

  • October 2017

Published In

Volume / Issue

  • 40 / 11

Start / End Page

  • 622 - 628

PubMed ID

  • 28777392

Pubmed Central ID

  • 28777392

Electronic International Standard Serial Number (EISSN)

  • 1724-6040

International Standard Serial Number (ISSN)

  • 0391-3988

Digital Object Identifier (DOI)

  • 10.5301/ijao.5000628

Language

  • eng