TY - JOUR
T1 - Comparison of outcomes in women versus men using a continuous-flow left ventricular assist device as a bridge to transplantation
AU - Bogaev, Roberta C.
AU - Pamboukian, Salpy V.
AU - Moore, Stephanie A.
AU - Chen, Leway
AU - John, Ranjit
AU - Boyle, Andrew J.
AU - Sundareswaran, Kartik S.
AU - Farrar, David J.
AU - Frazier, O. H.
N1 - Funding Information:
The HeartMate II bridge-to-transplantation trial was sponsored by Thoratec Corporation, Pleasanton, Calif.
PY - 2011/5
Y1 - 2011/5
N2 - Background: The use of large, pulsatile left ventricular assist devices (LVADs) has been limited in women because of their small body size. Methods: We compared the survival outcomes, quality of life, and adverse events in 465 patients (104 women, 361 men) with advanced systolic heart failure in their first 18 months of support with the HeartMate II (Thoratec Corp, Pleasanton, CA) continuous-flow LVAD for bridge to transplantation. Results: During the first 18 months, there were no differences in survival between women and men while on LVAD support (73% ± 3% vs 73% ± 5%, p = 0.855) but fewer women (40%) underwent heart transplantation than did men (55%; p = 0.001). More women continued on support after 18 months (p = 0.007). Median duration of support was 238 days for women and 184 days for men (p = 0.003). Mortality was 20% for women and 19% for men (p = 0.89). Adverse events were similar, with the exception of hemorrhagic stroke, which occurred more frequently in women (0.10 vs 0.04 events/patient-year, p = 0.02), and device-related infections, which occurred less frequently in women (0.23 vs 0.44, p = 0.006). Functional capacity and quality of life at 6 months improved significantly in women and men. Conclusions: Continuous-flow left ventricular assistance as a bridge to transplantation is associated with similar survival rates in women and men. Differences observed in higher stroke rates and fewer infections among women require further study.
AB - Background: The use of large, pulsatile left ventricular assist devices (LVADs) has been limited in women because of their small body size. Methods: We compared the survival outcomes, quality of life, and adverse events in 465 patients (104 women, 361 men) with advanced systolic heart failure in their first 18 months of support with the HeartMate II (Thoratec Corp, Pleasanton, CA) continuous-flow LVAD for bridge to transplantation. Results: During the first 18 months, there were no differences in survival between women and men while on LVAD support (73% ± 3% vs 73% ± 5%, p = 0.855) but fewer women (40%) underwent heart transplantation than did men (55%; p = 0.001). More women continued on support after 18 months (p = 0.007). Median duration of support was 238 days for women and 184 days for men (p = 0.003). Mortality was 20% for women and 19% for men (p = 0.89). Adverse events were similar, with the exception of hemorrhagic stroke, which occurred more frequently in women (0.10 vs 0.04 events/patient-year, p = 0.02), and device-related infections, which occurred less frequently in women (0.23 vs 0.44, p = 0.006). Functional capacity and quality of life at 6 months improved significantly in women and men. Conclusions: Continuous-flow left ventricular assistance as a bridge to transplantation is associated with similar survival rates in women and men. Differences observed in higher stroke rates and fewer infections among women require further study.
KW - heart failure
KW - heart-assist devices
KW - women
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U2 - 10.1016/j.healun.2010.12.009
DO - 10.1016/j.healun.2010.12.009
M3 - Article
C2 - 21257321
AN - SCOPUS:79953807776
SN - 1053-2498
VL - 30
SP - 515
EP - 522
JO - Journal of Heart and Lung Transplantation
JF - Journal of Heart and Lung Transplantation
IS - 5
ER -