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Influence of the Type of Circulatory/Ventricular Assistance in the Primary Graft Failure and Heart Transplantation Mortality

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DOI: 10.4236/wjcd.2019.98047    72 Downloads   189 Views

ABSTRACT

OBJECTIVES: In recent years, the percentage of heart transplantation (HT) with short/medium-term assistance devices has increased. This study aims at analyzing primary graft failure and in-hospital mortality according to the type of care. MATERIAL AND METHODS: From January 2013 to December 2017 all patients undergoing urgent HT with circulatory/ventricular assistance were retrospectively and consecutively recruited. Combined transplants, retransplantations and pediatric transplants were excluded. The sample was divided in 10 groups according to the type of shot/medium term assistance devices. RESULTS: A total of 53 patients were recruited, 79% men, average age 49 ± 13 years. 26 patients (51%) had mechanical ventilation at the time of the HT. Primary graft failure occurred in 20 patients (38.5%), whilst it was more frequent in patients assisted with ECMO (8 patients in group 1 (45%) and 7 in group 2 (54%), p 0.5). 14 deaths (27%) were registered, whereas a higher mortality was observed in the group assisted with ECMO (6 patients in group 1 (34%) and 4 in group 2 (31%), p 0.6). Mortality was 17% in the group of non-urgent Levitronix. CONCLUSIONS: Despite not showing statistical significance due to the low number of patients in some subgroups, hospital mortality was high in HT patients with circulatory assistance. A trend towards a higher incidence of primary graft failure and mortality in patients assisted with ECMO was observed. The direct implantation of a centrifugal pump as a bridge to urgent transplantation could identify a subgroup with a better prognosis.

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López-Vilella, R. , Sánchez-Lázaro, I. , Cabanes, M. , Moncho, A. , Bertolín, L. , Costa, R. , Puigdollers, I. , Dolz, L. , Jauregui, I. , Puerta, S. and Bonet, L. (2019) Influence of the Type of Circulatory/Ventricular Assistance in the Primary Graft Failure and Heart Transplantation Mortality. World Journal of Cardiovascular Diseases, 9, 545-552. doi: 10.4236/wjcd.2019.98047.

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