title: Low incidence of gastrointestinal bleeding and pump thrombosis in patients receiving the INCOR LVAD system in the long-term follow-up.
abstract: BACKGROUND
  Left ventricular assist device (LVAD) implantation improves survival and quality of life in patients with advanced heart failure (HF). Despite these advantages, LVADs are not free from risks. Among all adverse events (AE), pump thrombosis and bleeding, especially of the gastrointestinal (GI) tract, have been reported to occur with increasing frequency in some CF-LVADs. The INCOR LVAD system is a third-generation, continuous flow, axial pump with active magnetic levitation, avoiding the potential downsides of mechanical bearings.
  
  
  METHODS
  The aim of this retrospective study was to review the Italian clinical experience with the INCOR LVAD and to determine the prevalence of GI bleeding and pump thrombosis. All patients implanted between January 2006 and May 2012 were considered eligible.
  
  
  RESULTS
  The total population consisted of 42 patients. LVAD indication was BTT in 36 (86%) and DT in 6 (14%) patients; 31 patients (74%) were INTERMACS class 1 or 2. Mean support time was 525 ± 570 days. The 1-year and 2-year survival rates were 74% and 60%, respectively. The most frequent AE was driveline infection (0.33 events PPY) followed by stroke with consequence (0.17 events PPY), sepsis (0.07 events PPY), and right HF (0.05 events PPY). No episodes of pump thrombosis or GI bleeding were observed.
  
  
  CONCLUSIONS
  In this cohort of high-risk, advanced HF patients, the INCOR LVAD provided effective support with improved survival. Moreover, the absence of GI bleeding and pump thrombosis demonstrates a favorable characteristic of this device. Further prospective studies are needed to confirm these data.
authors.affiliation: Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo - Italy.
authors.forename: Attilio
authors.initials: A
authors.lastname: Iacovoni
authors.affiliation: Division of Cardiac Surgery, Città della Salute e della Scienza di Torino, Turin - Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Centofanti
authors.affiliation: Division of Cardiac Surgery, Città della Salute e della Scienza di Torino, Turin - Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Attisani
authors.affiliation: Cardiothoracic and Vascular Department, Niguarda Ca' Granda Hospital, Milan - Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Verde
authors.affiliation: Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo - Italy.
authors.forename: Amedeo
authors.initials: A
authors.lastname: Terzi
authors.affiliation: Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo - Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Senni
authors.affiliation: Cardiothoracic Department, University Hospital Udine, Udine - Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Maiani
authors.affiliation: Division of Cardiac Surgery, Città della Salute e della Scienza di Torino, Turin - Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Baronetto
authors.affiliation: Cardiothoracic Department, University Hospital Udine, Udine - Italy.
authors.forename: Ugo
authors.initials: U
authors.lastname: Livi
authors.affiliation: Cardiothoracic and Vascular Department, Niguarda Ca' Granda Hospital, Milan - Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Frigerio
authors.affiliation: Division of Cardiac Surgery, Città della Salute e della Scienza di Torino, Turin - Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Rinaldi
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology* / Q000209:etiology; D006333:Heart Failure / Q000503:physiopathology / Q000601:surgery*; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D013927:Thrombosis / Q000453:epidemiology* / Q000209:etiology; D016896:Treatment Outcome