Outcomes in patients with smaller body surface area after HeartMate 3 left ventricular assist device implantation.
Citation: Artificial Organs. 46(3):460-470, 2022 Mar.PMID: 34516000Institution: MedStar Heart & Vascular Institute | MedStar Washington Hospital CenterDepartment: Surgical Critical CareForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Body Surface Area | *Heart-Assist Devices | Body Mass Index | Cohort Studies | Diabetes Mellitus/ep [Epidemiology] | Diastole | Female | Humans | Male | Middle Aged | Patient Readmission | Retrospective Studies | Stroke/ep [Epidemiology] | Thrombosis/ep [Epidemiology]Year: 2022ISSN:- 0160-564X
- Molina, Ezequiel J:
- https://orcid.org/0000-0001-7332-7483
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 34516000 | Available | 34516000 |
BACKGROUND: Due to anatomic and physiologic concerns, prior generations of the left ventricular assist devices (LVAD) have frequently been denied to patients with small body size. However, outcomes in patients with small body surface area (BSA) following HeartMate 3 (HM3) LVAD implantation remain relatively unknown.
CONCLUSIONS: These findings demonstrate comparable outcomes in patients with small body size and suggest that this parameter should not be an exclusion criterion on patients who are otherwise candidates for HM3 LVAD implantation. Copyright (c) 2021 International Center for Artificial Organs and Transplantation and Wiley Periodicals LLC.
METHODS: A cohort of 220 patients implanted at a single center was divided into two groups: BSA <=1.8 m2 (small BSA, n = 37) and BSA >1.8 m2 (large BSA, n = 183). We investigated baseline characteristics and clinical outcomes including survival and incidence of adverse events.
RESULTS: Small BSA patients were older (60 vs. 57 years), more likely female (60% vs. 20%), had a lower body mass index (24 vs. 32 kg/m2 ), lower incidence of diabetes (32% vs. 51%), history of stroke (5% vs. 19%), and left ventricular thrombus (0% vs. 11%). They had smaller left ventricular end diastolic diameter (64.8 vs. 69.3 mm). Pump speed and pump flows at discharge were lower in the small BSA group. Survival at 1 year and 2 years was 86% versus 87% and 86% versus 79% for small versus large BSA groups (p = 0.408), respectively. The rates of adverse events were similar between groups and there were no cases of confirmed pump thrombosis. The incidence of readmissions for low flow alarms was higher in the small BSA group (0.55 vs. 0.24 EPPY).
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