title: Left ventricular assist device for end-stage heart failure: results of the first LVAD destination program in the Netherlands.
abstract: OBJECTIVE
  Mechanical circulatory support with a continuous-flow left ventricular assist device (LVAD) may be a valuable treatment in end-stage heart failure patients for an extended period of time. The purpose of this study was to evaluate the safety and efficacy of implantation of a continuous-flow LVAD in end-stage heart failure patients within the first destination program in the Netherlands.
  
  
  METHODS
  A third-generation LVAD was implanted in 16 heart failure patients (age 61 ± 8; 81 % male; left ventricular ejection fraction 20 ± 6 %) as destination therapy. All patients were ineligible for heart transplant. At baseline, 3 and 6 months, New York Heart Association (NYHA) functional class, quality-of-life and exercise capacity were assessed. Clinical adverse events were registered.
  
  
  RESULTS
  Survival at 30 days and 6 months was 88 and 75 %, respectively. In the postoperative phase, 6 (38 %) patients required continuous veno-venous haemofiltration for renal failure and 2 (13 %) patients required extracorporeal membrane oxygenation because of severe right ventricular failure. During follow-up, NYHA functional class and quality-of-life improved from 3.7 ± 0.1 to 2.3 ± 0.1 and 57 ± 5 to 23 ± 3 at 6 months (P < 0.001), respectively. The 6 min walking distance improved from 168 ± 42 m to 291 ± 29 m at 6 months (P = 0.001).
  
  
  CONCLUSIONS
  Continuous-flow LVAD therapy is a promising treatment for patients with end-stage heart failure ineligible for heart transplant.
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands.
authors.forename: M L A
authors.initials: ML
authors.lastname: Haeck
authors.forename: S L M A
authors.initials: SL
authors.lastname: Beeres
authors.forename: U
authors.initials: U
authors.lastname: Höke
authors.forename: M
authors.initials: M
authors.lastname: Palmen
authors.forename: L E
authors.initials: LE
authors.lastname: Couperus
authors.forename: V
authors.initials: V
authors.lastname: Delgado
authors.forename: E A
authors.initials: EA
authors.lastname: Logeman
authors.forename: J J
authors.initials: JJ
authors.lastname: Maas
authors.forename: R J M
authors.initials: RJ
authors.lastname: Klautz
authors.forename: M J
authors.initials: MJ
authors.lastname: Schalij
authors.forename: H F
authors.initials: HF
authors.lastname: Verwey