Left Ventricular Assist Device Implantation in Hypertrophic and Restrictive Cardiomyopathy: A Systematic Review

Jayakumar Sreenivasan, Risheek Kaul, Muhammad Shahzeb Khan, Sagar Ranka, Ryan T. Demmer, Melana Yuzefpolskaya, Wilbert S. Aronow, Haider J. Warraich, Stephen Pan, Julio A. Panza, Howard A. Cooper, Srihari S. Naidu, Paolo C. Colombo

Research output: Contribution to journalReview articlepeer-review

Abstract

Left ventricular assist device (LVAD) implantation in patients with advanced heart failure due to hypertrophic or restrictive cardiomyopathy (HCM/RCM) presents technical and physiologic challenges. We conducted a systematic review of observational studies to evaluate the utilization and clinical outcomes associated with LVAD implantation in patients with HCM/RCM and compared these to patients with dilated or ischemic cardiomyopathy (DCM/ICM). We searched MEDLINE, EMBASE, and Scopus from inception through May 2019 and included appropriate studies describing the use of an LVAD in patients with HCM/RCM. We identified six studies with a total of 2,766 patients with HCM/RCM and advanced heart failure, among whom 338 patients (12.2%) underwent LVAD implantation. In patients listed for transplant, the rate of LVAD implantation was significantly lower in patients with HCM/RCM compared to that in patients with DCM/ICM (4.4% vs. 18.2%, p < 0.001). Adverse clinical outcomes were significantly higher in HCM/RCM than in DCM/ICM, including operative/short-term mortality (14.0% vs. 9.0%), right ventricular failure (50.0% vs. 21.0%), infection (15.5% vs. 11.2%), bleeding (40.2% vs. 12.5%), renal failure (15.0% vs. 5.1%), stroke (5.0% vs. 2.4%), and arrhythmias (18.0% vs. 7.7%) (all p values <0.001).

Original languageEnglish (US)
Pages (from-to)239-244
Number of pages6
JournalASAIO Journal
DOIs
StateAccepted/In press - 2021

Bibliographical note

Publisher Copyright:
© ASAIO 2020.

Keywords

  • dilated cardiomyopathy
  • hypertrophic cardiomyopathy
  • left ventricular assist devices
  • mechanical circulatory support
  • refractory heart failure
  • restrictive cardiomyopathy

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