Outcome of right ventricular assist device implantation following left ventricular assist device implantation: Systematic review and meta-analysis
| Autor: | Ludwig K. von Segesser, Constantin Mork, Christian Appenzeller-Herzog, Gregory Reid, Brigita Gahl, Denis Berdajs, Friedrich Eckstein |
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| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Ventricular Dysfunction Right Hemorrhage 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Right heart failure Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Retrospective Studies Advanced and Specialized Nursing Heart Failure business.industry General Medicine Right Ventricular Assist Device Treatment Outcome 030228 respiratory system Ventricular assist device Meta-analysis Cardiology Heart-Assist Devices Cardiology and Cardiovascular Medicine business Safety Research |
| DOI: | 10.5451/unibas-ep83456 |
| Popis: | Objectives: The main aim was a systematic evaluation of the current evidence on outcomes for patients undergoing right ventricular assist device (RVAD) implantation following left ventricular assist device (LVAD) implantation. Methods: This systematic review was registered on PROSPERO (CRD42019130131). Reports evaluating in-hospital as well as follow-up outcome in LVAD and LVAD/RVAD implantation were identified through Ovid Medline, Web of Science and EMBASE. The primary endpoint was mortality at the hospital stay and at follow-up. Pooled incidence of defined endpoints was calculated by using random effects models. Results: A total of 35 retrospective studies that included 3260 patients were analyzed. 30 days mortality was in favour of isolated LVAD implantation 6.74% (1.98–11.5%) versus 31.9% (19.78–44.02%) p = 0.001 in LVAD with temporary need for RVAD. During the hospital stay the incidence of major bleeding was 18.7% (18.2–19.4%) versus 40.0% (36.3–48.8%) and stroke rate was 5.6% (5.4–5.8%) versus 20.9% (16.8–28.3%) and was in favour of isolated LVAD implantation. Mortality reported at short-term as well at long-term was 19.66% (CI 15.73–23.59%) and 33.90% (CI 8.84–59.96%) in LVAD respectively versus 45.35% (CI 35.31–55.4%) p ⩽ 0.001 and 48.23% (CI 16.01–80.45%) p = 0.686 in LVAD/RVAD group respectively. Conclusion: Implantation of a temporary RVAD is allied with a worse outcome during the primary hospitalization and at follow-up. Compared to isolated LVAD support, biventricular mechanical circulatory support leads to an elevated mortality and higher incidence of adverse events such as bleeding and stroke. |
| Databáze: | OpenAIRE |
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