Clinical results, adverse events, and change in end-organ function in elderly patients with heartmateii left ventricular assist device: Japanese multicenter study

behalf of the Japanese HeartMateII Investigators

Research output: Contribution to journalArticle

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Abstract

Background: Advanced age has an adverse impact on clinical results in left ventricular assist device (LVAD) patients. We compared the clinical results of patients aged >60 years with younger patients using a national Japanese database. Methods and Results: Between April 2013 and December 2016, 300 patients underwent HeartMateII implantation. Of these, 37 patients were ≥60 years at LVAD implantation, and the clinical results of these patients were compared with the other younger 263 patients. At 1 and 3 years the on-device survival was 95%, 91% in younger patients, and 85%, 75% in older patients, respectively (P=0.016), although age was not a risk factor on the multivariate analysis. There was no significant difference between the groups in incidence of various adverse events except stroke. In the propensity-matching cohort, the incidence of stroke was significantly higher in patients aged >60 years (P=0.047). In patients aged >60 years, improvement of renal function was transient and there was no improvement later than 3 months, and recovery of serum albumin level to preoperative value was delayed. Conclusions: There were significant differences in the stroke incidence and recovery of end-organ functions after LVAD implantation. This may have important implications for patient selection in future destination therapy in Japan, where quality of life is an important issue in LVAD support.

Original languageEnglish
Pages (from-to)409-418
Number of pages10
JournalCirculation Journal
Volume82
Issue number2
DOIs
Publication statusPublished - 2018

Keywords

  • Elderly
  • HeartMate II
  • J-MACS
  • Left ventricular assist device

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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