Objective: INTERMACS scale is considered a valid score system to stratify patients ́risk profile(morbidity and mortality) after mechanical circulatory support(MCS). We investigated outcomes of patients implanted with Jarvik2000 and enrolled in the Italian Registry Methods: From June2006 to September2011, 65 consecutive end-stage heart failure adult patients(58males, mean BSA1.90m2, 53%ischemic cardiomyopathy) were enrolled in the Jarvik2000 Italian Registry. Mean age was63±8 yrs(median65 yrs), 95% were uneligible to heart transplantation. In particular, two groups of patients were identified: long term survivors(group A,on device1 yr,N=23) and early deaths(group B,on device<1 month,N=12). Results: Overall mean time of patients on LVAD was 320days and mean time of patients discharged out of hospital(72%) was 445days. Overall survival was mainly impacted by peri-operative mortality. 12 patients died in early post-operative time(< 30 days) due to right ventricular failure(5), sepsis(3), bleeding(3) and coagulopaty(1). Late deaths were due to hemorrhagic stroke(5), non device related sepsis(5). No pump failure occurred in the whole series of patients. No significant difference in mean age, gender, etiology, pre-operative hemodynamics were found between the 2 groups. Pre-implant INTERMACS mean class was 3.5 in group A and 2.3 in group B(p=0.005). In group B, 5 patients had temporary MCS and 3 had CVVH before VAD implantation. Overall, probability of survival excluding early deaths, was 89%,70%,61% at 180 days, 1 and 2 years respectively. Conclusions: In our experience, preoperative higher INTERMACS class was correlated with higher survival. These results re- inforce the importance of elective LVAD implantation before development of inotropic dependency(cardiogenic shock) in permanent MCS patients.
Preoperative Intermacs scale and outcomes of all comers undergoing LVAD implantation: results from the Jarvik 2000 Italian Registry
DE BONIS , MICHELE;
2012-01-01
Abstract
Objective: INTERMACS scale is considered a valid score system to stratify patients ́risk profile(morbidity and mortality) after mechanical circulatory support(MCS). We investigated outcomes of patients implanted with Jarvik2000 and enrolled in the Italian Registry Methods: From June2006 to September2011, 65 consecutive end-stage heart failure adult patients(58males, mean BSA1.90m2, 53%ischemic cardiomyopathy) were enrolled in the Jarvik2000 Italian Registry. Mean age was63±8 yrs(median65 yrs), 95% were uneligible to heart transplantation. In particular, two groups of patients were identified: long term survivors(group A,on device1 yr,N=23) and early deaths(group B,on device<1 month,N=12). Results: Overall mean time of patients on LVAD was 320days and mean time of patients discharged out of hospital(72%) was 445days. Overall survival was mainly impacted by peri-operative mortality. 12 patients died in early post-operative time(< 30 days) due to right ventricular failure(5), sepsis(3), bleeding(3) and coagulopaty(1). Late deaths were due to hemorrhagic stroke(5), non device related sepsis(5). No pump failure occurred in the whole series of patients. No significant difference in mean age, gender, etiology, pre-operative hemodynamics were found between the 2 groups. Pre-implant INTERMACS mean class was 3.5 in group A and 2.3 in group B(p=0.005). In group B, 5 patients had temporary MCS and 3 had CVVH before VAD implantation. Overall, probability of survival excluding early deaths, was 89%,70%,61% at 180 days, 1 and 2 years respectively. Conclusions: In our experience, preoperative higher INTERMACS class was correlated with higher survival. These results re- inforce the importance of elective LVAD implantation before development of inotropic dependency(cardiogenic shock) in permanent MCS patients.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
