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. 2015 Feb;23(2):102-8.
doi: 10.1007/s12471-014-0602-4.

Left ventricular assist device for end-stage heart failure: results of the first LVAD destination program in the Netherlands

M L A Haeck  1 , S L M A Beeres, U Höke, M Palmen, L E Couperus, V Delgado, E A Logeman, J J Maas, R J M Klautz, M J Schalij, H F Verwey
Affiliations

Left ventricular assist device for end-stage heart failure: results of the first LVAD destination program in the Netherlands

M L A Haeck et al. Neth Heart J. 2015 Feb.

Abstract

Purpose: Mechanical circulatory support with a continuous-flow left ventricular assist device (LVAD) may be a valuable treatment in end-stage heart failure patients for an extended period of time. The purpose of this study was to evaluate the safety and efficacy of implantation of a continuous-flow LVAD in end-stage heart failure patients within the first destination program in the Netherlands.

Methods: A third-generation LVAD was implanted in 16 heart failure patients (age 61 ± 8; 81 % male; left ventricular ejection fraction 20 ± 6 %) as destination therapy. All patients were ineligible for heart transplant. At baseline, 3 and 6 months, New York Heart Association (NYHA) functional class, quality-of-life and exercise capacity were assessed. Clinical adverse events were registered.

Results: Survival at 30 days and 6 months was 88 and 75 %, respectively. In the postoperative phase, 6 (38 %) patients required continuous veno-venous haemofiltration for renal failure and 2 (13 %) patients required extracorporeal membrane oxygenation because of severe right ventricular failure. During follow-up, NYHA functional class and quality-of-life improved from 3.7 ± 0.1 to 2.3 ± 0.1 and 57 ± 5 to 23 ± 3 at 6 months (P < 0.001), respectively. The 6 min walking distance improved from 168 ± 42 m to 291 ± 29 m at 6 months (P = 0.001).

Conclusion: Continuous-flow LVAD therapy is a promising treatment for patients with end-stage heart failure ineligible for heart transplant.

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Figures

Fig. 1
Fig. 1
Flow chart of left ventricular assist device destination program
Fig. 2
Fig. 2
Individual New York Heart Association (NYHA) functional class at baseline, 3 and 6 months follow-up. Mean NYHA functional class improved significantly from 3.7 ± 0.1 pre-implantation to 2.6 ± 0.2 at 3 and 2.3 ± 0.1 at 6 months (P < 0.001)
Fig. 3
Fig. 3
Quality of life, as assessed by the Minnesota Living with Heart Failure questionnaire, demonstrated significant improvement at 3- and 6- month follow-up compared with baseline. Data are presented as mean ± standard error of the mean *P < 0.001 compared with baseline
Fig. 4
Fig. 4
Exercise capacity at baseline and at 6-month follow-up. Panel A shows a significant increase in 6 min walking distance. Panel B shows an improvement in peak oxygen consumption. Data are presented as mean ± standard error of the mean
See this image and copyright information in PMC

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