Trends in the Utilisation and In-Hospital Mortality Associated With Short-Term Mechanical Circulatory Support for Heart Failure With Reduced Ejection Fraction

Abstract

Heart failure with reduced ejection fraction (HFrEF) is a systolic dysfunction with an ejection fraction below 40% and the prevalence of it is substantially increasing in the United States. Mechanical circulatory support (MCS) devices have increasingly been used for the management of HFrEF and are associated with improved outcomes. The National Inpatient Sample database was used to identify hospitalisations with mechanical circulatory support for HFrEF from 2005 to 2014. This study observed a reduction in the utilisation of intra-aortic balloon pump (IABP), which is partially replaced by percutaneous left ventricular assist device (pLVAD) and extracorporeal membrane oxygenation (ECMO) for the management of HFrEF. In-hospital mortality in IABP and ECMO recipients decreased during the study period while mortality with pLVAD did not change. Finally, technology for the short-term MCS in HFrEF hospitalisations continues to improve, however, there is still some space for updated technology in future.

Keywords: Extracorporeal membrane oxygenation; Heart failure with reduced ejection fraction; Intra-aortic balloon pump; Mechanical circulatory support; Percutaneous left ventricular assist device.