How many acute heart failure patients need a ventricular assist device?
OBJECTIVE
The most severe forms of acute heart failure have a dismal prognosis despite modern invasive treatment. For some of these patients, improved outcome must relay on early institution of ventricular assist devices (VAD). We aimed to estimate the potential VAD need in acute heart failure.


METHODS
All patients admitted to the ICU or CCU for acute heart failure (AHF) in 2003/04 (n=302) were reviewed. Non-survivors with severe acute heart failure, i.e. cardiogenic shock and postcardiotomy HF, were individually reviewed to assess eligibility for VAD-treatment.


RESULTS
Cardiogenic shock and postcardiotomy HF was present in 23% (n=69) and 19% (n=57) of the AHF patients. Overall in hospital mortality in these groups was 38% (n=48). Of these, 15 were less than 75 years of age, without serious comorbidities and thus deemed to be potential candidates for VAD-treatment.


CONCLUSIONS
This survey indicates that 12% of patients with severe acute heart failure are potential candidates for VAD-treatment. Extending these figures to a national level, indicate that approximately 70 patients per year could be candidates for short-term VAD-treatment in Norway.
Hermansen
Stig Eggen
SE
Department of Cardiothoracic and Vascular Surgery, University Hospital, North Norway, Tromsø, Norway. Stig.Eggen.Hermansen@unn.no
Hansen
Magna
M
Roaldsen
Marius
M
Muller
Stig
S
How
Ole-Jakob
OJ
Myrmel
Truls
T
D000368:Aged; D015897:Comorbidity; D005260:Female; D006301:Health Services Needs and Demand; D006333:Heart Failure / Q000453:epidemiology / Q000401:mortality / Q000628:therapy*; D006353:Heart-Assist Devices / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009664:Norway / Q000453:epidemiology; D012189:Retrospective Studies; D012770:Shock, Cardiogenic / Q000628:therapy