PT  - JOURNAL ARTICLE
AU  - Jayan Parameshwar
AU  - Rachel Hogg
AU  - Sally Rushton
AU  - Rhiannon Taylor
AU  - Steven Shaw
AU  - Jenny Mehew
AU  - Andre Simon
AU  - Guy A MacGowan
AU  - Jonathan R Dalzell
AU  - Nawwar Al Attar
AU  - Rajamiyer Venkateswaran
AU  - Hoong Sern Lim
AU  - Stephan Schueler
AU  - Steven Tsui
AU  - Nicholas Robert Banner
TI  - Patient survival and therapeutic outcome in the UK bridge to transplant left ventricular assist device population
AID  - 10.1136/heartjnl-2018-313355
DP  - 2019 Feb 01
TA  - Heart
PG  - 291--296
VI  - 105
IP  - 4
4099  - http://heart.bmj.com/content/105/4/291.short
4100  - http://heart.bmj.com/content/105/4/291.full
SO  - Heart2019 Feb 01; 105
AB  - Objective To study the survival and patient outcome in a population of UK patients supported by an implantable left ventricular assist device (LVAD) as a bridge to heart transplantation.Methods Data on all adult patients (n=342) who received a HeartMate II or HVAD as a first long-term LVAD between January 2007 and 31 December 2013 were extracted from the UK Ventricular Assist Device (VAD) Database in November 2015. Outcomes analysed include survival on a LVAD, time to urgent listing, heart transplantation and complications including those needing a pump exchange.Results 112 patients were supported with the Thoratec HeartMate II and 230 were supported with the HeartWare HVAD. Median duration of support was 534 days. During the study period, 81 patients required moving to the UK urgent waiting list for heart transplantation. Of the 342 patients, 85 (24.8%) received a heart transplant, this included 63 on the urgent list. Thirty-day survival was 88.9%, while overall patient survival at 3 years from LVAD implant was 49.6%. 156 patients (46%) died during LVAD support; the most common cause of death on a VAD was a cerebrovascular accident. There was no significant difference between the two devices used in any outcome.Conclusions In a population of patients with advanced heart failure, who have a very poor prognosis, support with an implantable LVAD allowed a quarter to receive a heart transplant in a 3-year period. Overall survival of the cohort was about 50%. With improvement in technology and in post-LVAD management, it is likely that outcomes will improve further.