title: Long-term support of patients receiving a left ventricular assist device for advanced heart failure: a follow-up analysis of the Registry to Evaluate the HeartWare Left Ventricular Assist System.
abstract: OBJECTIVE
  The Registry to Evaluate the HeartWare Left Ventricular Assist System (ReVOLVE) is an investigator-initiated multicentre, prospective, single-arm database established to collect post-Conformité Européenne Mark clinical information on patients receiving the HeartWare® Ventricular Assist System (HVAD®). The number of patients requiring longer periods of mechanical circulatory support is ever increasing and so further investigation into long-term outcomes in bridge-to-transplant populations is necessary.
  
  
  METHODS
  Data were collected on 254 commercial implants performed between February 2009 and March 2012 from nine centres in Europe (7 centres) and Australia (2 centres). Patients were followed to device explant, heart transplant or death, and the outcomes of patients who remained on support longer than 2 years were analysed. Summary statistics were used to describe patient demographics, adverse events, length of support and outcomes for this long-term cohort.
  
  
  RESULTS
  A total of 124 patients (49% of the original ReVOLVE population) were on support for more than 2 years (range: 731-2108 days), 76 of whom are still alive on support. Overall survival through 5 years was 59%.
  
  
  CONCLUSIONS
  Owing to the low rate of heart transplants, a significant number of patients receiving a left ventricular assist device as a bridge to transplant remain on support for prolonged periods, often exceeding 2, 3 and even 4 years. Real-world use of the HVAD system continues to show excellent outcomes for patients on the device, including those on support beyond 2 years.
authors.affiliation: Hannover Medical School, Hannover, Germany schmitto.jan@mh-hannover.de.
authors.forename: Jan D
authors.initials: JD
authors.lastname: Schmitto
authors.affiliation: Medical University of Vienna, Vienna, Austria.
authors.forename: Daniel
authors.initials: D
authors.lastname: Zimpfer
authors.affiliation: Oslo University Hospital, Oslo, Norway.
authors.forename: Arnt E
authors.initials: AE
authors.lastname: Fiane
authors.affiliation: Royal Perth Hospital, Perth, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Larbalestier
authors.affiliation: Papworth Hospital NHS Foundation Trust, Cambridge, UK.
authors.forename: Steven
authors.initials: S
authors.lastname: Tsui
authors.affiliation: St Vincent's Clinic, Sydney, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Jansz
authors.affiliation: Royal Brompton and Harefield Hospital, London, UK.
authors.forename: Andre
authors.initials: A
authors.lastname: Simon
authors.affiliation: Freeman Hospital, Newcastle upon Tyne, UK.
authors.forename: Stephan
authors.initials: S
authors.lastname: Schueler
authors.affiliation: Spectrum Health, Grand Rapids, MI, USA.
authors.forename: Martin
authors.initials: M
authors.lastname: Strueber
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000401:mortality / Q000601:surgery*; D016027:Heart Transplantation / Q000706:statistics & numerical data; D006353:Heart-Assist Devices / Q000009:adverse effects; D006801:Humans; D053208:Kaplan-Meier Estimate; D008134:Long-Term Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D011358:Product Surveillance, Postmarketing / Q000379:methods; D012042:Registries; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: HeartWare; Left ventricular assist device; Long-term support; ReVOLVE