Original articleAdult cardiacHospital Readmissions After Continuous-Flow Left Ventricular Assist Device Implantation: Incidence, Causes, and Cost Analysis
Section snippets
Patients and Methods
Between January 2007 and December 2013, 126 patients underwent implantation with a CF-LVAD at the University of Wisconsin Hospital and Clinics. This study was approved by our Institutional Review Board (IRB). The data were prospectively acquired and maintained in our IRB-approved VAD database. The cohort was divided into two groups: (1) the group of patients who were readmitted to the hospital while using device support and (2) the group of patients who were never readmitted to the hospital
Results
Our study population consisted of 126 consecutive CF-LVAD patients. Four patients who died before discharge during the index hospitalization were excluded from the analysis. Indications at device implantation included bridge to transplantation (BTT) in 103 (84%) patients and destination therapy (DT) in 19 patients (16%). The median age of the patients was 55 years (mean, 53 ± 13 years), and 16% were female. The cause of cardiomyopathy was ischemic in 55 patients (45%). Three different devices
Comment
Mechanical circulatory support devices have been used for patients with end-stage heart failure over a few decades. The transition from pulsatile to CF-LVADs has been associated with a significant decline in overall rates of adverse events, significantly improved durability, and much better long-term survival for both the bridge to transplantation and destination therapy indications [2]. Although CF-LVADs have considerably improved clinical outcomes and patient survival, there is no doubt that
References (19)
- et al.
Sixth INTERMACS annual report: a 10,000-patient database
J Heart Lung Transplant
(2014) - et al.
Survival on the heart transplant waiting list: impact of continuous flow left ventricular assist device as bridge to transplant
Ann Thorac Surg
(2014) - et al.
Cost-effectiveness of left ventricular assist devices (LVADs) for patients with advanced heart failure: analysis of the British NHS bridge to transplant (BTT) program
Int J Cardiol
(2014) - et al.
Readmissions after ventricular assist device: etiologies, patterns, and days out of hospital
Ann Thorac Surg
(2013) - et al.
Readmissions after implantation of axial flow left ventricular assist device
J Am Coll Cardiol
(2013) - et al.
Factors determining post-operative readmissions after left ventricular assist device implantation
J Heart Lung Transplant
(2014) - et al.
Incidence and management of gastrointestinal bleeding with continuous flow assist devices
Ann Thorac Surg
(2012) - et al.
GI bleeding in patients with continuous-flow left ventricular assist devices: a systematic review and meta-analysis
Gastrointest Endosc
(2014) - et al.
Severely impaired von Willebrand factor-dependent platelet aggregation in patients with a continuous-flow left ventricular assist device (HeartMate II)
J Am Coll Cardiol
(2009)