Abstract | OBJECTIVES: METHODS: Between March 2004 and December 2013, 256 potential orthotopic heart transplantation candidates underwent continuous-flow left ventricular assist device implantation at Columbia University. Preimplantation right heart catheterization data were available for 227 patients. Patients were divided into 2 groups on the basis of preimplantation pulmonary vascular resistance: low (<5 Wood units) (n = 182) and high (≥5 Wood units) (n = 45). Postimplantation and post- transplantation outcomes were compared between the groups. RESULTS: Pulmonary vascular resistance in the high resistance group decreased significantly during left ventricular assist device support (P < .001). Post- transplantation in-hospital mortality was significantly higher in patients with high vascular resistance (P < .05). However, 3-year survival after transplantation was similar between groups (85.0% and 79.0% for low and high vascular resistance, respectively; P = .45). CONCLUSIONS: Continuous-flow left ventricular assist device therapy reduced pulmonary vascular resistance. Subsequent orthotopic heart transplantation in patients with significantly elevated pulmonary vascular resistance resulted in higher in-hospital mortality but similar 3-year survival.
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Authors | Masaki Tsukashita, Hiroo Takayama, Koji Takeda, Jiho Han, Paolo C Colombo, Melana Yuzefpolskaya, Veli K Topkara, Arthur Reshad Garan, Donna M Mancini, Paul A Kurlansky, Yoshifumi Naka |
Journal | The Journal of thoracic and cardiovascular surgery
(J Thorac Cardiovasc Surg)
Vol. 150
Issue 5
Pg. 1352-60, 1361.e1-2
(Nov 2015)
ISSN: 1097-685X [Electronic] United States |
PMID | 26253875
(Publication Type: Journal Article)
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Copyright | Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved. |
Topics |
- Academic Medical Centers
- Adult
- Aged
- Cardiac Catheterization
- Female
- Heart Failure
(diagnosis, mortality, physiopathology, therapy)
- Heart Transplantation
(adverse effects, mortality)
- Heart-Assist Devices
- Hospital Mortality
- Humans
- Hypertension, Pulmonary
(diagnosis, mortality, physiopathology, therapy)
- Kaplan-Meier Estimate
- Male
- Middle Aged
- New York City
- Patient Selection
- Predictive Value of Tests
- Prosthesis Design
- Pulmonary Artery
(physiopathology)
- Retrospective Studies
- Risk Assessment
- Risk Factors
- Time Factors
- Treatment Outcome
- Vascular Resistance
- Ventricular Function, Left
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