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Observational Study
. 2022 May 1;50(5):e426-e433.
doi: 10.1097/CCM.0000000000005424. Epub 2022 Jan 3.

Outcome of Temporary Circulatory Support As a Bridge-to-Left Ventricular Assist Device Strategy in Cardiogenic Shock Patients

Auriane Bidaut  1 , Erwan Flécher  1 , Nicolas Nesseler  1 , Karl Bounader  1 , André Vincentelli  1 , Mouhammed Moussa  1 , Clément Delmas  1 , Jean Porterie  1 , Karine Nubret  1 , Mathieu Pernot  1 , Michel Kindo  1 , Clément Schneider  1 , Philippe Gaudard  2   3 , Philippe Rouvière  2   3 , Magali Michel  1 , Thomas Sénage  1 , Aude Boignard  1 , Olivier Chavanon  1 , Constance Verdonk  1 , Marylou Para  1 , Baptiste Maille  1 , Vlad Gariboldi  1 , Matteo Pozzi  1 , Elisabeth Hugon-Vallet  1 , Pierre-Yves Litzler  1 , Frédéric Anselme  1 , Katrien Blanchart  1 , Gerard Babatasi  1 , Marie Bielefeld  1 , Sandrine Grosjean  1 , Costin Radu  1 , David Hamon  1 , Thierry Bourguignon  1 , Thibaud Genet  1 , Romain Eschalier  1 , Nicolas D'Ostrevy  1 , Hélène Nougue  1 , Anne Cécile Martin  1 , Fabrice Vanhuyse  1 , Hugues Blangy  1 , Christophe Leclercq  1 , Raphael P Martins  1 , Vincent Galand  1
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Free article
Observational Study

Outcome of Temporary Circulatory Support As a Bridge-to-Left Ventricular Assist Device Strategy in Cardiogenic Shock Patients

Auriane Bidaut et al. Crit Care Med. .
Free article

Abstract

Objectives: Temporary circulatory support (TCS) as a bridge-to-left ventricular assist device (BTL) in cardiogenic shock patients has been increasing, but limited data exists on this BTL strategy. We aimed at analyzing the outcome of BTL patients in a population of cardiogenic shock patients compared with those without TCS at the time of the left ventricular assist device (LVAD) surgery and identify predictors of postoperative mortality in this specific population.

Design: A multicenter retrospective observational study conducted in 19 centers from 2006 to 2016.

Setting: Nineteen French centers.

Patients: A total of 329 cardiogenic shock patients at the time of LVAD implantation were analyzed. Patients were divided in three groups: those under TCS at the time of LVAD implantation (n = 173), those with TCS removal before LVAD surgery (n = 24), and those who did not undergo a bridging strategy (n = 152). Primary endpoint was 30-day mortality.

Interventions: None.

Measurements and main results: Among the BTL group, 68 (39.3%), 18 (10.4%), and 15 (8.7%) patients were under venoarterial extracorporeal membrane oxygenation, Impella, and IABP support alone, and 72 patients (20.6%) were under multiple TCS support. BTL patients presented similar 30 days survival compared with the TCS removal and non-BTL groups. However, BTL group had a significantly longer ICU duration stay, with two-fold duration of mechanical ventilation time, but the three groups experienced similar postoperative complications. Multivariate analysis identified three independent predictors of mortality in the BTL group: combined surgery with LVAD, body mass index (BMI), and heart failure (HF) duration. BTL strategy was not an independent predictor of mortality in cardiogenic shock patients who underwent LVAD.

Conclusions: BTL strategy is not associated with a lower survival among cardiogenic shock patients with LVAD implantation. Predictors of mortality are combined surgery with LVAD, higher BMI, and HF duration.

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Conflict of interest statement

Drs. Delmas and Gaudard received funding from Abiomed. Drs. Delmas and Blangy received funding from Abbott. Dr. Blangy received funding from Boston and Zoll. The remaining authors have disclosed that they do not have any potential conflicts of interest.

References

    1. Miller LW, Pagani FD, Russell SD, et al.; HeartMate II Clinical Investigators: Use of a continuous-flow device in patients awaiting heart transplantation. N Engl J Med. 2007; 357:885–896
    1. Ponikowski P, Voors AA, Anker SD, et al.; ESC Scientific Document Group: 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: The task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016; 37:2129–2200
    1. Yancy CW, Jessup M, Bozkurt B, et al.: 2013 ACCF/AHA guideline for the management of heart failure: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013; 62:e147–e239
    1. Stewart GC, Givertz MM: Mechanical circulatory support for advanced heart failure: Patients and technology in evolution. Circulation. 2012; 125:1304–1315
    1. Kirklin JK, Pagani FD, Kormos RL, et al.: Eighth annual INTERMACS report: Special focus on framing the impact of adverse events. J Heart Lung Transplant. 2017; 36:1080–1086

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