Continuous Flow Left Ventricular Assist Devices: One Year Survival by Era. A Single Center Experience

Background: Continuous flow Left ventricular assist device (LVAD) implantation has steadily increased world-wide since the approval of the HeartMate II (Thoratec, Pleasanton, Calif) by the FDA in 2008.

Post approval studies demonstrated 1-year survival rates of up to 85%.

The present study a single center experience on the effects of era on survival rates of continuous flow LVAD supported patients

Methods: The first continuous flow LVAD was implanted at our institution on July 2008. The 59 patients that were implanted until March 2015 were divided in two groups by the era of implantation. The first 34 patients that were implanted between 07/2008 and 12/2012 formed the first group (era 1). The second group consisted of following 25 patients that were implanted between 01/2013 and 03/2015 (era 2). The effects of clinical, hemodynamic and metabolic parameters on one year survival rates between the two eras were examined. Patients bridged to transplantation during the first year were regarded as survivors. Right ventricular function was graded from normal to severe (1-5)

Results: The one year survival (or transplanted) rates improved in Era 2 as compared to era 1: 77% (26 patients) and 92% (23 patients) for eras 1 and 2 respectively (p<0.05).

In general, patients in the second era were somewhat older, had slightly better functional capacity, better RV function with more favorable hemodynamic and metabolic parameters.

Conclusions: Our single center experience with continuous flow LVAD implantation shows improved one year survival in the contemporary era.

The differences between the eras may be explained by improved surgical expertise and patient selection by the cardiologist and by the optimization of the general post-operative management of the patients by the LVAD team.