title: Outcomes of Adult Patients with Small Body Size Supported with a Continuous-Flow Left Ventricular Assist Device.
abstract: There is insufficient data on patients with small body size to determine if this should be considered a risk factor for continuous-flow left ventricular assist device (CF-LVAD) support. We sought to evaluate survival outcomes, adverse events, and functional status of CF-LVAD patients with body surface area (BSA) <1.5 m in a large national registry. Adults with BSA < 1.5 m (n = 128) implanted with a HeartMate II (HMII)-LVAD from the Interagency Registry for Mechanically Assisted Circulatory Support registry from April 2008 to December 2012 formed this cohort. Outcomes were compared with HMII bridge to transplant (BTT) and destination therapy (DT) post approval studies. The majority of patients were female (n = 106, 83%). A total of 64% (n = 82) were implanted for BTT and 36% (n = 46) for DT. The median BSA (range) was 1.44 (1.19-1.49) and 1.45 (1.25-1.49) m for BTT and DT, respectively. Overall survival 1 year post implant was 81% ± 5% for BTT and 84% ± 6% for DT. The most common adverse events for BTT and DT patients were bleeding (0.91, 0.88 events/patient year) and driveline infection (16%, 0.28 events/patient year). Six months post implantation, 87% of BTT and 77% of DT patients were New York Heart Association functional class I or II. Post implant survival, functional status improvement, and adverse event profile for adult BTT and DT HMII patients with BSA < 1.5 m are favorable and comparable with outcomes published in the overall patient population.
authors.affiliation: From the *Richard DeVos Heart & Lung Transplant Program, Spectrum Health, Grand Rapids, Michigan; †Center for Heart and Vascular Care, Divisions of Cardiology and Pulmonary & Critical Care Medicine, University of North Carolina, Chapel Hill, North Carolina; ‡Department of Medicine, Division of Cardiology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York; §Department of Thoracic and Cardiovascular Surgery and the Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio; ¶Division of Cardiothoracic Surgery, University of Minnesota, Minneapolis, Minnesota; ‖Research and Scientific Affairs, St. Jude Medical, St. Paul, Minnesota; and #Center for Cardiac Support, Cardiovascular Surgery Research, Cullen Cardiovascular Research Laboratories, Texas Heart Institute, Houston, Texas.
authors.forename: Sangjin
authors.initials: S
authors.lastname: Lee
authors.forename: Jason N
authors.initials: JN
authors.lastname: Katz
authors.forename: Ulrich P
authors.initials: UP
authors.lastname: Jorde
authors.forename: Nader
authors.initials: N
authors.lastname: Moazami
authors.forename: Ranjit
authors.initials: R
authors.lastname: John
authors.forename: Kartik S
authors.initials: KS
authors.lastname: Sundareswaran
authors.forename: David J
authors.initials: DJ
authors.lastname: Farrar
authors.forename: O H
authors.initials: OH
authors.lastname: Frazier
mesh_terms: D000328:Adult; D000368:Aged; D049628:Body Size; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006353:Heart-Assist Devices / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries