title: Quality of life and functional status in patients surviving 12 months after left ventricular assist device implantation.
abstract: BACKGROUND
  As left ventricular assist device (LVAD) support duration increases, quality of life (QoL) becomes a concern. We reviewed the QoL in patients on LVAD support for >or=1 year.
  
  
  METHODS
  We retrospectively reviewed our prospective database for patients supported >or=1 year by HeartMate pulsatile- (HM1) or continuous-flow (HM2) LVADs from 2000 to 2009. Transplant or death before 1 year merited exclusion. Metabolic equivalents of tasks (METs), the Minnesota Living with Heart Failure Questionnaire (MLHFQ), the 6-minute walk distance (6MWD), and New York Heart Association (NYHA) class were reviewed. Complications and re-admissions were assessed.
  
  
  RESULTS
  Thirty patients were supported for >or=1 year (7 HM1s, 23 HM2s). Mean support duration was 594 +/- 173 days. Mean QoL metrics/functional status indicators at 12 months were: 6MWD, 393 +/- 290 m; MET tolerance, 3.3 +/- 1; MLHFQ, 35 +/- 31; and NYHA, 1.4 +/- 0.6. Mean re-admissions/year was 2.9 +/- 2, with a duration of 13.8 +/- 21 days. Three patients were never re-admitted. Mean out-of-hospital time was 471 +/- 172 days (87.3% of days). Infectious complications led to 43% of re-admissions and occurred in the: drive-line (47%) at 442 +/- 236 days; blood (37%) at 472 +/- 257 days; and LVAD pocket (20%) at 550 +/- 202 days. Twenty-three patients (77%) required additional operations (1.7 +/- 1.8/year). The most common indication was drive-line infection, but ranged from ischemic bowel to defibrillator exchange. Eight required LVAD exchanges for mechanical (n = 4), electrical (n = 3), and thrombotic (n = 1) issues.
  
  
  CONCLUSIONS
  Although LVAD support is not without complications, patients spend the majority of time outside the hospital enjoying a good quality of life.
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, The Johns Hopkins University Medical Institutions, Baltimore, Maryland 21287, USA.
authors.forename: Jeremiah G
authors.initials: JG
authors.lastname: Allen
authors.forename: Eric S
authors.initials: ES
authors.lastname: Weiss
authors.forename: Justin M
authors.initials: JM
authors.lastname: Schaffer
authors.forename: Nishant D
authors.initials: ND
authors.lastname: Patel
authors.forename: Susan L
authors.initials: SL
authors.lastname: Ullrich
authors.forename: Stuart D
authors.initials: SD
authors.lastname: Russell
authors.forename: Ashish S
authors.initials: AS
authors.lastname: Shah
authors.forename: John V
authors.initials: JV
authors.lastname: Conte
mesh_terms: D000328:Adult; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D055686:Metabolic Equivalent; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012189:Retrospective Studies; D017741:Survivors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000628:therapy*; D016138:Walking