Age and preoperative total bilirubin level can stratify prognosis after extracorporeal pulsatile left ventricular assist device implantation
2011 (English)In: Circulation Journal, ISSN 1346-9843, E-ISSN 1347-4820, Vol. 75, no 1, 121-128 p.Article in journal (Refereed) Published
Background: In Japan, the TOYOBO left ventricular assist device (LVAD) has been commercially available for heart failure patients as of 2010, but clinical risk stratification before implantation has not been widely performed. Methods and Results: In the present study data from 47 patients (age 38.6 +/- 14.6 [SD] years, male 74.5%, non-ischemic 74.5%) implanted with a TOYOBO LVAD between November 2002 and February 2010 were analyzed. Kaplan-Meier survival analysis showed significantly higher mortality in the patients who had cardiogenic shock preoperatively (P=0.031). Multivariate analysis revealed that the preoperative total bilirubin level (odds ratio [OR] 1.312, Pless than0.001) and age (OR 1.076, P=0.013) were independent risk factors for death. Perioperative necessity of a right ventricular assist device was also an independent risk factor for poor prognosis. Conclusions: LVAD implantation is preferable before the patient experiences hemodynamic collapse. The preoperative total bilirubin level can be used to predict prognosis after device implantation in end-stage heart failure patients.
Place, publisher, year, edition, pages
Japanese Circulation Society , 2011. Vol. 75, no 1, 121-128 p.
Heart failure; Heart-assist device; Hemodynamics; Risk factor; Transplantation
IdentifiersURN: urn:nbn:se:liu:diva-111202DOI: 10.1253/circj.CJ-10-0770ISI: 000285814300021PubMedID: 21116070OAI: oai:DiVA.org:liu-111202DiVA: diva2:754441