Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
Cardiovascular Surgery
Clinical Results, Adverse Events, and Change in End-Organ Function in Elderly Patients With HeartMateII Left Ventricular Assist Device ― Japanese Multicenter Study ―
Daisuke YoshiokaKoichi TodaMinoru OnoTakeshi NakataniAkira ShioseYoshiro MatsuiKenji YamazakiYoshikatsu SaikiAkihiko UsuiHiroshi NiinamiGoro MatsumiyaHirokuni AraiYoshiki Sawaon behalf of the Japanese HeartMateII Investigators
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2018 Volume 82 Issue 2 Pages 409-418

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Abstract

Background:Advanced age has an adverse impact on clinical results in left ventricular assist device (LVAD) patients. We compared the clinical results of patients aged >60 years with younger patients using a national Japanese database.

Methods and Results:Between April 2013 and December 2016, 300 patients underwent HeartMateII implantation. Of these, 37 patients were ≥60 years at LVAD implantation, and the clinical results of these patients were compared with the other younger 263 patients. At 1 and 3 years the on-device survival was 95%, 91% in younger patients, and 85%, 75% in older patients, respectively (P=0.016), although age was not a risk factor on the multivariate analysis. There was no significant difference between the groups in incidence of various adverse events except stroke. In the propensity-matching cohort, the incidence of stroke was significantly higher in patients aged >60 years (P=0.047). In patients aged >60 years, improvement of renal function was transient and there was no improvement later than 3 months, and recovery of serum albumin level to preoperative value was delayed.

Conclusions:There were significant differences in the stroke incidence and recovery of end-organ functions after LVAD implantation. This may have important implications for patient selection in future destination therapy in Japan, where quality of life is an important issue in LVAD support.

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© 2018 THE JAPANESE CIRCULATION SOCIETY
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