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. 2022 Jun 15;62(1):ezac032.
doi: 10.1093/ejcts/ezac032.

The European Registry for Patients with Mechanical Circulatory Support of the European Association for Cardio-Thoracic Surgery: third report

Theo M M H de By  1 , Felix Schoenrath  2   3 , Kevin M Veen  4 , Paul Mohacsi  5 , Julia Stein  2   3 , Khalid M M Alkhamees  6 , Kyriakos Anastasiadis  7 , Alexander Berhnardt  8 , Friedhelm Beyersdorf  9   10 , Kadir Caliskan  4 , David Reineke  11 , Kevin Damman  12 , Arnt Fiane  13 , Angeliki Gkouziouta  14 , Can Gollmann-Tepeköylü  15 , Finn Gustafsson  16 , Michal Hulman  17 , Attilio Iacovoni  18 , Antonio Loforte  19 , Bela Merkely  20 , Francesco Musumeci  21 , Petr Němec  8 , Ivan Netuka  22 , Mustafa Özbaran  23 , Evgenij Potapov  2   3 , Yuri Pya  24 , Gregorio Rábago  25 , Faiz Ramjankhan  26 , Hermann Reichenspurner  27 , Diyar Saeed  28 , Elena Sandoval  29 , Bernard Stockman  30 , Marc Vanderheyden  30 , Laurens Tops  31 , Thorsten Wahlers  32 , Michael Zembala  33 , Daniel Zimpfer  34 , Thierry Carrel  35 , Jan Gummert  36 , Bart Meyns  37
Affiliations

The European Registry for Patients with Mechanical Circulatory Support of the European Association for Cardio-Thoracic Surgery: third report

Theo M M H de By et al. Eur J Cardiothorac Surg. .

Erratum in

Abstract

Objectives: In the third report of the European Registry for Patients with Mechanical Circulatory Support of the European Association for Cardio-Thoracic Surgery, outcomes of patients receiving mechanical circulatory support are reviewed in relation to implant era.

Methods: Procedures in adult patients (January 2011-June 2020) were included. Patients from centres with <60% follow-ups completed were excluded. Outcomes were stratified into 3 eras (2011-2013, 2014-2017 and 2018-2020). Adverse event rates (AERs) were calculated and stratified into early phase (<3 months) and late phase (>3 months). Risk factors for death were explored using univariable Cox regression with a stepwise time-varying hazard ratio (<3 vs >3 months).

Results: In total, 4834 procedures in 4486 individual patients (72 hospitals) were included, with a median follow-up of 1.1 (interquartile range: 0.3-2.6) years. The annual number of implants (range: 346-600) did not significantly change (P = 0.41). Both Interagency Registry for Mechanically Assisted Circulatory Support class (classes 4-7: 23, 25 and 33%; P < 0.001) and in-hospital deaths (18.5, 17.2 and 11.2; P < 0.001) decreased significantly between eras. Overall, mortality, transplants and the probability of weaning were 55, 25 and 2% at 5 years after the implant, respectively. Major infections were mainly noted early after the implant occurred (AER<3 months: 1.44 vs AER>3 months: 0.45). Bilirubin and creatinine levels were significant risk factors in the early phase but not in the late phase after the implant.

Conclusions: In its 10 years of existence, EUROMACS has become a point of reference enabling benchmarking and outcome monitoring. Patient characteristics and outcomes changed between implant eras. In addition, both occurrence of outcomes and risk factor weights are time dependent.

Keywords: End-stage heart failure; Mechanical circulatory support; Registry; Ventricular assist device.

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