title: Clinical strategies and outcomes in advanced heart failure patients older than 70 years of age receiving the HeartMate II left ventricular assist device: a community hospital experience.
abstract: OBJECTIVE
  The primary objective of this study was to determine outcomes in left ventricular assist device (LVAD) patients older than age 70 years.
  
  
  BACKGROUND
  Food and Drug Administration approval of the HeartMate II (Thoratec Corporation, Pleasanton, California) LVAD for destination therapy has provided an attractive option for older patients with advanced heart failure.
  
  
  METHODS
  Fifty-five patients received the HeartMate II LVAD between October 5, 2005, and January 1, 2010, as part of either the bridge to transplantation or destination therapy trials at a community hospital. Patients were divided into 2 age groups: ≥ 70 years of age (n = 30) and < 70 years of age (n = 25). Outcome measures including survival, length of hospital stay, adverse events, and quality of life were compared between the 2 groups.
  
  
  RESULTS
  Pre-operatively, all patients were in New York Heart Association functional class IV refractory to maximal medical therapy. Kaplan-Meier survival for patients ≥ 70 years of age (97% at 1 month, 75% at 1 year, and 70% at 2 years) was not statistically different from patients <7 0 years of age (96% 1 month, 72% at 1 year, and 65% at 2 years, p = 0.806). Average length of hospital stay for the ≥ 70-year age group was 24 ± 15 days, similar to that of the < 70-year age group (23 ± 14 days, p = 0.805). There were no differences in the incidence of adverse events between the 2 groups. Quality of life and functional status improved significantly in both groups.
  
  
  CONCLUSIONS
  The LVAD patients ≥ 70 years of age have good functional recovery, survival, and quality of life at 2 years. Advanced age should not be used as an independent contraindication when selecting a patient for LVAD therapy at experienced centers.
authors.affiliation: Sharp Memorial Hospital, San Diego, California, USA. robandtl@aol.com
authors.forename: Robert M
authors.initials: RM
authors.lastname: Adamson
authors.forename: Marcia
authors.initials: M
authors.lastname: Stahovich
authors.forename: Suzanne
authors.initials: S
authors.lastname: Chillcott
authors.forename: Sam
authors.initials: S
authors.lastname: Baradarian
authors.forename: Joseph
authors.initials: J
authors.lastname: Chammas
authors.forename: Brian
authors.initials: B
authors.lastname: Jaski
authors.forename: Peter
authors.initials: P
authors.lastname: Hoagland
authors.forename: Walter
authors.initials: W
authors.lastname: Dembitsky
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006333:Heart Failure / Q000401:mortality* / Q000601:surgery*; D006353:Heart-Assist Devices; D006764:Hospitals, Community; D006801:Humans; D007902:Length of Stay; D008297:Male; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome