Outcomes in patients with smaller body surface area after HeartMate 3 left ventricular assist device implantation
Autor: | Farooq H. Sheikh, Sriram Rao, S. Ahmed, Maria E. Rodrigo, A. Kadakkal, Ezequiel J. Molina, Samer S. Najjar, Mark Hofmeyer, Amiti Jain, Michael Hockstein, Phillip H. Lam |
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Rok vydání: | 2021 |
Předmět: |
Male
medicine.medical_specialty Body Surface Area medicine.medical_treatment Biomedical Engineering Diastole Medicine (miscellaneous) Bioengineering Single Center Patient Readmission Body Mass Index Cohort Studies Biomaterials Internal medicine Diabetes Mellitus medicine Humans Adverse effect Stroke Retrospective Studies Body surface area business.industry Incidence (epidemiology) Thrombosis General Medicine Middle Aged Left ventricular thrombus medicine.disease Ventricular assist device Cardiology Female Heart-Assist Devices business |
Zdroj: | Artificial Organs. 46:460-470 |
ISSN: | 1525-1594 0160-564X |
Popis: | BACKGROUND Due to anatomic and physiologic concerns, prior generations of the left ventricular assist devices (LVAD) have frequently been denied to patients with small body size. However, outcomes in patients with small body surface area (BSA) following HeartMate 3 (HM3) LVAD implantation remain relatively unknown. METHODS A cohort of 220 patients implanted at a single center was divided into two groups: BSA ≤1.8 m2 (small BSA, n = 37) and BSA >1.8 m2 (large BSA, n = 183). We investigated baseline characteristics and clinical outcomes including survival and incidence of adverse events. RESULTS Small BSA patients were older (60 vs. 57 years), more likely female (60% vs. 20%), had a lower body mass index (24 vs. 32 kg/m2 ), lower incidence of diabetes (32% vs. 51%), history of stroke (5% vs. 19%), and left ventricular thrombus (0% vs. 11%). They had smaller left ventricular end diastolic diameter (64.8 vs. 69.3 mm). Pump speed and pump flows at discharge were lower in the small BSA group. Survival at 1 year and 2 years was 86% versus 87% and 86% versus 79% for small versus large BSA groups (p = 0.408), respectively. The rates of adverse events were similar between groups and there were no cases of confirmed pump thrombosis. The incidence of readmissions for low flow alarms was higher in the small BSA group (0.55 vs. 0.24 EPPY). CONCLUSIONS These findings demonstrate comparable outcomes in patients with small body size and suggest that this parameter should not be an exclusion criterion on patients who are otherwise candidates for HM3 LVAD implantation. |
Databáze: | OpenAIRE |
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