Use Of Prone Positioning In Patients With Left Ventricular Assist Devices
HFSA ePoster Library. Stewart S. 09/10/21; 343423; 194
Scott Stewart
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Abstract
Discussion Forum (0)
Background: HeartMate 3 (HM3) and Heartware (HVAD) are the contemporary left ventricular assist device (LVAD) options with limited comparative data.
Methods: We retrospectively included adult patients (>18 years) undergoing LVAD implantation at our center (Aug 2016 to Aug 2019). Overall baseline characteristics and major clinical outcomes were computed and compared using MOMENTUM 3 and ENDURANCE trial definitions. Subgroup analysis after propensity matching baseline characteristics and INTERMACS profile was also performed.
Results: A total of 93 patients were included, with six patients excluded as they died during the index implantation. Out of the remaining 87 patients, 33 (37.9%) had HM3 and 54 (62.1%) had HVAD. No significant difference in baseline characteristics were noted (Table 1A), except more patients with higher INTERMACS profile received HVAD (53.7% vs 27.3%; p=0.01). Device thrombosis and TIA/stroke were higher among HVAD patients (0 vs 18.5%; p = 0.009; 0 vs 11.1%: p= .04, respectively) (Table1B). No significant differences in overall mortality, GI bleeding, or driveline infections were noted. Propensity-matched cohort showed a higher rate of device thrombosis and TIA/stroke among HVAD (0 vs 13%: p = 0.07 and 0 vs 13%: p= 0.07, respectively) but was statistically non-significant (Table 1C).
Cconclusion: HVAD patients had higher thromboembolic complications, but no significant difference in other outcomes. Larger multicenter studies are needed to confirm these findings.
Methods: We retrospectively included adult patients (>18 years) undergoing LVAD implantation at our center (Aug 2016 to Aug 2019). Overall baseline characteristics and major clinical outcomes were computed and compared using MOMENTUM 3 and ENDURANCE trial definitions. Subgroup analysis after propensity matching baseline characteristics and INTERMACS profile was also performed.
Results: A total of 93 patients were included, with six patients excluded as they died during the index implantation. Out of the remaining 87 patients, 33 (37.9%) had HM3 and 54 (62.1%) had HVAD. No significant difference in baseline characteristics were noted (Table 1A), except more patients with higher INTERMACS profile received HVAD (53.7% vs 27.3%; p=0.01). Device thrombosis and TIA/stroke were higher among HVAD patients (0 vs 18.5%; p = 0.009; 0 vs 11.1%: p= .04, respectively) (Table1B). No significant differences in overall mortality, GI bleeding, or driveline infections were noted. Propensity-matched cohort showed a higher rate of device thrombosis and TIA/stroke among HVAD (0 vs 13%: p = 0.07 and 0 vs 13%: p= 0.07, respectively) but was statistically non-significant (Table 1C).
Cconclusion: HVAD patients had higher thromboembolic complications, but no significant difference in other outcomes. Larger multicenter studies are needed to confirm these findings.
Background: HeartMate 3 (HM3) and Heartware (HVAD) are the contemporary left ventricular assist device (LVAD) options with limited comparative data.
Methods: We retrospectively included adult patients (>18 years) undergoing LVAD implantation at our center (Aug 2016 to Aug 2019). Overall baseline characteristics and major clinical outcomes were computed and compared using MOMENTUM 3 and ENDURANCE trial definitions. Subgroup analysis after propensity matching baseline characteristics and INTERMACS profile was also performed.
Results: A total of 93 patients were included, with six patients excluded as they died during the index implantation. Out of the remaining 87 patients, 33 (37.9%) had HM3 and 54 (62.1%) had HVAD. No significant difference in baseline characteristics were noted (Table 1A), except more patients with higher INTERMACS profile received HVAD (53.7% vs 27.3%; p=0.01). Device thrombosis and TIA/stroke were higher among HVAD patients (0 vs 18.5%; p = 0.009; 0 vs 11.1%: p= .04, respectively) (Table1B). No significant differences in overall mortality, GI bleeding, or driveline infections were noted. Propensity-matched cohort showed a higher rate of device thrombosis and TIA/stroke among HVAD (0 vs 13%: p = 0.07 and 0 vs 13%: p= 0.07, respectively) but was statistically non-significant (Table 1C).
Cconclusion: HVAD patients had higher thromboembolic complications, but no significant difference in other outcomes. Larger multicenter studies are needed to confirm these findings.
Methods: We retrospectively included adult patients (>18 years) undergoing LVAD implantation at our center (Aug 2016 to Aug 2019). Overall baseline characteristics and major clinical outcomes were computed and compared using MOMENTUM 3 and ENDURANCE trial definitions. Subgroup analysis after propensity matching baseline characteristics and INTERMACS profile was also performed.
Results: A total of 93 patients were included, with six patients excluded as they died during the index implantation. Out of the remaining 87 patients, 33 (37.9%) had HM3 and 54 (62.1%) had HVAD. No significant difference in baseline characteristics were noted (Table 1A), except more patients with higher INTERMACS profile received HVAD (53.7% vs 27.3%; p=0.01). Device thrombosis and TIA/stroke were higher among HVAD patients (0 vs 18.5%; p = 0.009; 0 vs 11.1%: p= .04, respectively) (Table1B). No significant differences in overall mortality, GI bleeding, or driveline infections were noted. Propensity-matched cohort showed a higher rate of device thrombosis and TIA/stroke among HVAD (0 vs 13%: p = 0.07 and 0 vs 13%: p= 0.07, respectively) but was statistically non-significant (Table 1C).
Cconclusion: HVAD patients had higher thromboembolic complications, but no significant difference in other outcomes. Larger multicenter studies are needed to confirm these findings.
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