Aaronson, Keith D., Silvestry, Scott C., Maltais, Simon, Mallidi, Hari R., Frazier, O. H., Boyce, Steven W., Leadley, Katrin, Najarian, Kevin B., Slaughter, Mark S., Pagani, Francis D.
funding text
K.D.A. received contracted research support from HeartWare Inc. and Thoratec Corp., which is managed by the University of Michigan. S.C.S. is on the advisory board for HeartWare Inc. and Thoratec Corp. S.M. is on the advisory board for HeartWare Inc. O.H.F. received minimal travel reimbursement from HeartWare Inc. S.W.B. has ownership interest in HeartWare Inc. and Thoratec Corp. D.R.H. and K.B.N. are employees of HeartWare Inc. F.D.P. received contracted research support from HeartWare Inc. and Thoratec Corp., which is managed by the University of Michigan. None of the other authors have a financial relationship with a commercial entity that has an interest in the subject of the presented manuscript or other conflicts of interest to disclose.
abstract
Advanced heart failure patients who are classified as bridge to transplant (BTT) often remain on mechanical circulatory support (MCS) for long durations because of the limited supply of donor organs. Here, we present the outcomes of patients who have been supported by the HeartWare ventricular assist device system for more than 2 years. In the HeartWare BTT and continued access protocol trial, 74 of the 382 total patients (19.4%) had more than 2 years of MCS with a mean time of 1,045 days on device. The long-term group was more frequently female, was nonwhite, and had Interagency Registry for Mechanically Assisted Circulatory Support profiles 4-7. Postimplant adverse event rates including bleeding, cardiac arrhythmia, infection, stroke, renal dysfunction, and right heart failure were less frequent in the long-term cohort. In addition, the long-term cohort displayed significant improvements in Kansas City Cardiomyopathy Questionnaire Overall Summary Score, EuroQOL-5D Overall Health State Score, and 6 minute walk scores from baseline values. The rate of heart transplantation was lower for the long-term cohort, which may have been a result of their sex and blood type. However, most of these patients are still listed for cardiac transplantation and maintained their quality of life profiles through 3 years of support.