Mechanical Circulatory Support implanted in low-volume centre: Heart Team training counts more than caseload
Keywords:
end stage heart failure, ventricular assist devices, heart transplant
Abstract
Objectives: This study aims to determine if mechanical circulatory support is safely performedin low-volume centre. Methods. Retrospective studyincluding patients who received VAD from 2007 to 2017. In 2013, a heart failure team was created. Data were analysed according to pre and post heart team creation. Primary outcome was survival to transplant or ongoingMCS at 1-year. Results. 50 adult patients were examined; 35 male (70%), mean age 49+/- 8 years. Outcomes were: Death in16(32%), heart transplant in 24(48%), uneventful ongoing support 10(20%). Two groups of 25 patients were identified: 2007-2013 (mean-INTERMACS level 3.1) and 2014-2017 (mean-INTERMACS level 3.9) showing 1-year survivalof 56% and 80% respectively. Conclusions. MCS can be implanted at low-volume centres with good survivalrate. Heart failure team isprobably more important than institutional volume in determining outcomes of VAD therapy.
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2018-01-15
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