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Outcomes of patients after successful left ventricular assist device explantation: A EUROMACS study

ESC Heart Failure Jun 04, 2020

Antonides CFJ, Schoenrath F, de By TMMH, et al. - Researchers conducted an analysis of the European Registry for Patients with Mechanical Circulatory Support, to define long‐term results as well as clinical treatment after left ventricular assist device (LVAD) explantation. All adult patients with myocardial recovery and successful explantation were selected. Experts carried out a Kaplan–Meier analysis for freedom of the composite endpoint of mortality, heart transplantation, LVAD reimplantion, or heart failure (HF) relapse. Follow‐up post-explantation could be obtained in 28 (62%) cases. HF in 36%, 32%, and in 14% of the patients was attributable to dilated cardiomyopathy, myocarditis, and ischaemia, respectively, and 18% had miscellaneous aetiologies. HeartMate II was implanted in 14 (50%), HVAD in 11 (39%), HeartMate 3 in 2 (7%), and 1 unknown with a median span of support of 410 days. After 30 days and after 2 years, the freedom from the composite endpoint was identified to be 100% and 88%, respectively. Overall, findings revealed excellent survival post-LVAD explantation, with no requirement for heart transplantation or LVAD reimplantation. A relapse of significant HF happened in only a minority of the patients.

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