Outcomes of left ventricular assist device implantations at Karolinska University Hospital: A retrospective study

Abstract

Background: To descriptively present data and outcomes of left ventricular assist device (LVAD) implantations at Karolinska University Hospital. Methods: Data were collected from consecutive patients (n = 44) who were implanted with HeartMate 3 (HM3) at Karolinska University Hospital between 2017 and 2022. The study presents baseline characteristics, clinical course during the inpatient hospital care after implantation, adverse events, and clinical outcomes. Results: Median intensive care unit stay and hospital stay after HM3 implantation was 8 (interquartile range [IQR] 6; 15) and 28 days (IQR 22; 36), respectively. In total, 73% underwent ramp test at some point after the implantation. Death from all causes within 30 days postimplantation was 5%. A total of 21 patients (48%) underwent right heart catheterization, at a median of 0.5 years (IQR 0.3; 0.7) after implantation, and all exhibited optimally unloaded left ventricles. During the study period, 34% of the patients were transplanted, 5% were explanted, and 16% died with LVAD. In total, 11% and 5% suffered from early and late right ventricle failures, respectively. Acute renal failure affected 46% and 18% had driveline infection. Spontaneous cerebral hemorrhage and cerebral infarction affected 5% and 7% of the study population, respectively. Gastrointestinal bleeding affected 16%. The median LVAD duration was 10 months (IQR 5; 22). The 1-year survival rate with LVAD was 85%, and the 2-year survival rate was 80%. Conclusions: The results of this low-volume single-center retrospective study on LVAD implantations align with the results of other studies and international registries.

Keywords

• heart failure
• HeartMate 3
• heart transplantation
• left ventricular assist device
• mechanical circulatory support