| Autor: |
Deborah de Sá Pereira Belfort, Bruno Biselli, Mônica Samuel Avila, Renata Lopes Hames, Stephanie Itala Rizk, Fabrício Canova Calil, Bruna Carneiro Oliveira, Filomena Regina Barbosa Gomes Galas, Ludhmila Abrahão Hajjar, Nadine Oliveira Clausell, Livia Adams Goldraich, Ramez Anbar, Edimar Alcides Bocchi, Tadeu Thomé, Roberto Kalil Filho, Paulo Manuel Pêgo-Fernandes, Fabio Biscegli Jatene, Silvia Moreira Ayub-Ferreira |
| Jazyk: |
angličtina |
| Rok vydání: |
2024 |
| Předmět: |
|
| Zdroj: |
JHLT Open, Vol 6, Iss , Pp 100151- (2024) |
| Druh dokumentu: |
article |
| ISSN: |
2950-1334 |
| DOI: |
10.1016/j.jhlto.2024.100151 |
| Popis: |
Background: In middle-income countries, costs limit widespred use of left ventricular assist device (LVAD) as a strategy for end-stage heart failure. We aim to describe the experience of a LVAD program in a middle-income country in a hub-and-spoke model. Methods: Patients fulfilling strict inclusion and exclusion criteria were referred from different centers in Brazil for LVAD implantation through a philanthropy program financed via a Brazilian Federal Government tax exemption structure. LVAD implantation was performed in a hub-and-spoke model with a single implanting center. Data were collected retrospectively using hospital records and telephone contact with other centers. Patients who received LVAD implants external to the philanthropic program, either at this or other Brazilian centers, were not included. Results: Between January 1, 2013 and December 31, 2020, 20 adult patients underwent long-term continuous flow LVAD implantation with decentralization of postimplant patient care in regional centers. Patients were referred from 11 centers from 7 states in Brazil and underwent LVAD implantation through a philanthropy program. The median age was 52.5 years and 85% were Interagency Registry for Mechanically Assisted Circulatory Support profile 3 patients. Two patients had Chagas cardiomyopathy. The overall survival censored for competing risks at 1 and 2 years were 90% and 84%, respectively. Three patients (15%) underwent heart transplantation in the first 2 years after LVAD implantation. Twelve patients returned to their original centers and were followed remotely. Conclusions: This study presents a successful LVAD implantation program in a hub-and-spoke model in Brazil. Centralization of LVAD implantation with decentralization of postimplant patient care in regional centers is feasible and safe, enabling optimal allocation of resources in middle-income countries. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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