Acute kidney injury after implantation of a left ventricular assist device: a comparison of axial-flow (HeartMate II) and centrifugal-flow (HeartWare HVAD) devices

Autor: Masashi Kawabori, Andre C. Critsinelis, Reynolds M. Delgado, Ajith Nair, O.H. Frazier, Joggy George, Chitaru Kurihara, Tadahisa Sugiura, Jeffrey A. Morgan, Leo Simpson, Azeen Anjum, Whitson B. Etheridge, Andrew B. Civitello
Rok vydání: 2018
Předmět:
Male
Nephrology
medicine.medical_specialty
medicine.medical_treatment
Biomedical Engineering
Medicine (miscellaneous)
030204 cardiovascular system & hematology
urologic and male genital diseases
Biomaterials
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Internal medicine
medicine
Humans
Retrospective Studies
Heart Failure
urogenital system
business.industry
Proportional hazards model
Incidence
Acute kidney injury
Equipment Design
Perioperative
Acute Kidney Injury
Middle Aged
medicine.disease
United States
female genital diseases and pregnancy complications
Cardiac surgery
Survival Rate
030228 respiratory system
Ventricular assist device
Heart failure
Cohort
Cardiology
Equipment Failure
Female
Heart-Assist Devices
Cardiology and Cardiovascular Medicine
business
Zdroj: Journal of Artificial Organs. 21:285-292
ISSN: 1619-0904
1434-7229
Popis: Continuous-flow left ventricular assist devices (CF-LVADs) are increasingly being used to treat advanced, refractory chronic heart failure. Herein, we sought to determine the incidence of postoperative acute kidney injury (AKI) in axial-flow (HeartMate II; HM-II) and centrifugal-flow (HVAD) CF-LVAD recipients, as well as the effect of AKI on mortality. The study cohort comprised 520 patients who received a HM-II (n = 398) or HVAD (n = 122) at our center between November 2003 and March 2016. Their records were reviewed to determine the incidence of RIFLE-defined AKI after LVAD implantation. We compared the perioperative characteristics, postoperative complications, and survival rates of the patients with and without AKI and differentiated the outcomes based on device type (HM-II or HVAD). Seventy-five patients (14.4%) developed AKI postoperatively. Patients with AKI after LVAD implantation had significantly reduced survival compared to patients without AKI (p = 0.01). Cox proportional hazards models showed that AKI was a significant independent predictor of mortality (HR = 1.54, p = 0.03). Preoperative mechanical circulatory support and prolonged cardiopulmonary bypass time were independent predictors of AKI. The incidence of AKI was similar for HM-II and HVAD recipients (p = 0.25). There was no significant difference in AKI rates for the HM-II and HVAD recipients. Developing AKI adversely affected survival.
Databáze: OpenAIRE
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