title: Cerebrovascular Accident Rate Is Different Between Centrifugal and Axial-Flow Pumps, but Survival and Driveline Infection Rates Are Similar.
abstract: OBJECTIVE
  We analyzed the outcome of patients with implantable left ventricular assist devices (LVADs) at the University of Tokyo Hospital to compare those with centrifugal pumps (CE group: Duraheart and Evaheart) and those with axial-flow pumps (AX group: Heartmate II and Jarvik 2000).
  
  
  METHODS
  A total of 68 patients who underwent implantation of LVADs (Duraheart: n = 15; Evaheart: n = 23; Heartmate II: n = 22; Jarvik 2000: n = 8) as a bridge to transplantation at our institution from May 2011 to April 2015 were retrospectively reviewed. All patients were followed through December 2015.
  
  
  RESULTS
  The mean follow-up time of the CE group was 1.95 ± 0.92 year (total 74.1 patient-years) and that of the AX group was 1.56 ± 0.56 year (total 46.8 patient-years). Whether the patients underwent centrifugal or axial-flow pump implantations was not associated with survival or driveline infection according to log-rank test (1-year survival rate: 89% vs 100% [P = .221]; 1-year freedom rate: 40% vs 43% [P = .952]). The rates of freedom from cerebrovascular accident (CVA) at 1 year after LVAD implantation in the CE and AX groups were 70% and 96%, respectively (P < .001). The CE group showed a higher frequency of CVA (0.472 vs 0.021 event per patient-year).
  
  
  CONCLUSIONS
  Our findings indicate that overall survival and driveline infection rates are similar between centrifugal and axial-flow pumps, but they suggest that patients with centrifugal pumps are more likely to develop CVAs than those with axial-flow pumps.
authors.affiliation: Department of Cardiac Surgery, University of Tokyo Hospital, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kimura
authors.affiliation: Department of Cardiac Surgery, University of Tokyo Hospital, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Nawata
authors.affiliation: Department of Cardiac Surgery, University of Tokyo Hospital, Tokyo, Japan.
authors.forename: O
authors.initials: O
authors.lastname: Kinoshita
authors.affiliation: Department of Cardiac Surgery, University of Tokyo Hospital, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Yamauchi
authors.affiliation: Department of Cardiac Surgery, University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Itoda
authors.affiliation: Department of Cardiovascular Medicine, University of Tokyo Hospital, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Imamura
authors.affiliation: Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Hatano
authors.affiliation: Second Department of Internal Medicine, University of Toyama, Toyama, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kinugawa
authors.affiliation: Department of Cardiac Surgery, University of Tokyo Hospital, Tokyo, Japan. Electronic address: mono-tky@umin.ac.jp.
authors.forename: M
authors.initials: M
authors.lastname: Ono
mesh_terms: D000328:Adult; D005260:Female; D006333:Heart Failure / Q000401:mortality; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology; D015996:Survival Rate