title: Influence of inflow cannula length in axial-flow pumps on neurologic adverse event rate: results from a multi-center analysis.
abstract: BACKGROUND
  The application of axial-flow pumps in patients with end-stage heart failure reveals a significantly reduced infectious complication rate as compared with rates observed with pulsatile devices. The remaining adverse event rate relates mainly to thromboembolic complications with neurologic consequences. We investigated the dependence of the neurologic adverse event rate on the length of the inflow cannula.
  
  
  METHODS
  A total of 216 consecutive patients with an axial-flow pump (INCOR; Berlin Heart GmbH, Berlin, Germany) were included in a retrospective multi-center analysis. In 138 patients, a short inflow cannula (24-mm tip length into the left ventricle), and in 78 patients a long inflow cannula (tip length 34 mm) was applied.
  
  
  RESULTS
  Patients with a long inflow cannula (LC) demonstrated a better survival rate than those with a short inflow cannula (SC) at the end of the observation period (LC, 63.4%; SC, 52.9%; p = 0.05). The thromboembolic adverse event rate was also significantly lower. Only 3 of the 78 patients (3.8%) with an LC had a thromboembolic adverse event (thromboembolic events per patient-year = 0.11) as compared with 32 (23.2%) of SC patients (thromboembolic events per patient-year = 0.50, p < 0.001).
  
  
  CONCLUSIONS
  Patients with a long inflow cannula had a better survival rate and a lower incidence of cerebrovascular adverse events than patients with a short inflow cannula.
authors.affiliation: Wilhelm-Universität, Münster, Germany. christof.schmid@klinik.uni-regensburg.de
authors.forename: Christof
authors.initials: C
authors.lastname: Schmid
authors.forename: Michael
authors.initials: M
authors.lastname: Jurmann
authors.forename: Dietrich
authors.initials: D
authors.lastname: Birnbaum
authors.forename: Tiziano
authors.initials: T
authors.lastname: Colombo
authors.forename: Volkmar
authors.initials: V
authors.lastname: Falk
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Feltrin
authors.forename: Andrea
authors.initials: A
authors.lastname: Garatti
authors.forename: Michele
authors.initials: M
authors.lastname: Genoni
authors.forename: Gino
authors.initials: G
authors.lastname: Gerosa
authors.forename: Peter
authors.initials: P
authors.lastname: Göttel
authors.forename: Jan
authors.initials: J
authors.lastname: Gummert
authors.forename: Robert
authors.initials: R
authors.lastname: Halfmann
authors.forename: Dieter
authors.initials: D
authors.lastname: Hammel
authors.forename: Ewald
authors.initials: E
authors.lastname: Hennig
authors.forename: Friedrich
authors.initials: F
authors.lastname: Kaufmann
authors.forename: Marco
authors.initials: M
authors.lastname: Lanfranconi
authors.forename: Bart
authors.initials: B
authors.lastname: Meyns
authors.forename: Friedrich
authors.initials: F
authors.lastname: Mohr
authors.forename: Johannes
authors.initials: J
authors.lastname: Müller
authors.forename: Dimitar
authors.initials: D
authors.lastname: Nikolov
authors.forename: Kestutis
authors.initials: K
authors.lastname: Rucinskas
authors.forename: Hans-Heinrich
authors.initials: HH
authors.lastname: Scheld
authors.forename: Franz-Xaver
authors.initials: FX
authors.lastname: Schmid
authors.forename: Michael
authors.initials: M
authors.lastname: Schneider
authors.forename: Vytautas
authors.initials: V
authors.lastname: Sirvydis
authors.forename: René
authors.initials: R
authors.lastname: Tandler
authors.forename: Ettore
authors.initials: E
authors.lastname: Vitali
authors.forename: Dirk
authors.initials: D
authors.lastname: Vlasselaers
authors.forename: Michael
authors.initials: M
authors.lastname: Weyand
authors.forename: Markus
authors.initials: M
authors.lastname: Wilhelm
authors.forename: Roland
authors.initials: R
authors.lastname: Hetzer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization / Q000009:adverse effects*; D002543:Cerebral Hemorrhage / Q000209:etiology*; D005260:Female; D006333:Heart Failure / Q000628:therapy; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D020521:Stroke / Q000209:etiology*; D015996:Survival Rate; D013923:Thromboembolism / Q000209:etiology*