Quality of life after removal of left ventricular assist device for myocardial recovery.
BACKGROUND
Longer term quality of life (QOL) outcome in patients who have had a left ventricular assist device (LVAD) explanted due to myocardial recovery (bridge to recovery, BTR) remains uncertain. This study evaluates the QOL of those patients and compares them to bridge-to-transplant (BTT) and transplanted (Tx) patients.


METHODS
Anonymized QOL Short Form (SF)-36 questionnaires were sent to a total of 72 patients, including: 14 BTR patients (3.6 +/- 1.9 years since LVAD removal); 29 BTT patients (3.3 +/- 2.3 years since transplantation); and 29 Tx patients (3.8 +/- 0.6 years since transplantation).


RESULTS
Questionnaires were returned by 78.6%, 79.3% and 56.7% of patients from the BTR, BTT and Tx groups, respectively. In all but two of the domains of the SF-36 questionnaire, scores were significantly better in the BTR group compared with the BTT and Tx groups. Analysis of the two main dimensions and the total SF-36 score between the three groups showed that: (i) physical health dimension tended to be better in BTR (71.9 +/- 21) vs BTT (64.5 +/- 23.2) and Tx (41.4 +/- 48) groups (p = not statistically significant [NS]); (ii) mental health dimension was better in both BTR (78 +/- 16.1) and BTT (71.4 +/- 21.1) groups compared with the Tx group (39.4 +/- 44, p < 0.05); and (iii) total SF-36 score was significantly higher in the BTR and BTT groups compared with the Tx group (76.8 +/- 17.6 and 69 +/- 21.1 vs 41.4 +/- 48, p = NS).


CONCLUSIONS
BTR patients appear to have better QOL than both BTT and Tx patients. In addition, BTT patients seem to have a better QOL compared with Tx patients, suggesting that placement of ventricular assist devices could improve the physiologic outcome for transplanted patients.
George
Robert S
RS
Royal Brompton and Harefield NHS Trust, Magdi Yacoub Institute, Harefield Hospital, Harefield, Middlesex, UK.
Yacoub
Magdi H
MH
Bowles
Christopher T
CT
Hipkin
Mandy
M
Rogers
Paula
P
Hallas
Claire
C
Banner
Nicholas R
NR
Dreyfus
Gilles
G
Khaghani
Asghar
A
Birks
Emma J
EJ
D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D020878:Device Removal; D005260:Female; D016027:Heart Transplantation / Q000523:psychology*; D006353:Heart-Assist Devices / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011336:Probability; D011788:Quality of Life / Q000523:psychology*; D018570:Risk Assessment; D012737:Sex Factors; D011795:Surveys and Questionnaires; D020257:Ventricular Remodeling / Q000502:physiology*; D014850:Waiting Lists