Effect of pulmonary vascular resistance before left ventricular assist device implantation on short- and long-term post-transplant survival
Abstract Objectives Pulmonary hypertension is often considered a contraindication to orthotopic heart transplantation. Left ventricular assist device support may improve pulmonary hypertension by unloading the left ventricle, making patients eligible for transplantation. We sought to investigate the...
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| creator | Tsukashita, Masaki, MD, PhD Takayama, Hiroo, MD, PhD Takeda, Koji, MD, PhD Han, Jiho, BS Colombo, Paolo C., MD Yuzefpolskaya, Melana, MD Topkara, Veli K., MD Garan, Arthur Reshad, MD Mancini, Donna M., MD Kurlansky, Paul A., MD Naka, Yoshifumi, MD, PhD |
| description | Abstract Objectives Pulmonary hypertension is often considered a contraindication to orthotopic heart transplantation. Left ventricular assist device support may improve pulmonary hypertension by unloading the left ventricle, making patients eligible for transplantation. We sought to investigate the effect of continuous-flow left ventricular assist device support on pulmonary hypertension and compare post-transplantation outcomes in patients with preexisting pulmonary hypertension. Methods Between March 2004 and December 2013, 256 potential orthotopic heart transplantation candidates underwent continuous-flow left ventricular assist device implantation at Columbia University. Preimplantation right heart catheterization data were available for 227 patients. Patients were divided into 2 groups on the basis of preimplantation pulmonary vascular resistance: low ( |
| doi_str_mv | 10.1016/j.jtcvs.2015.07.012 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1731786996</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0022522315012222</els_id><sourcerecordid>1731786996</sourcerecordid><originalsourceid>FETCH-LOGICAL-c595t-29d66243a69f38d2560d9f3e5b7cac38891a0764dcb68b79c06e71c5627ba3893</originalsourceid><addsrcrecordid>eNqFks-O1SAUxhujca6jT2BiWLpp5c8AZaGJmcyoySQu1MQdofRUqRSuQJvMM_jS0rmjCzcSElj8Ps7h-07TPCe4I5iIV3M3F7vljmLCOyw7TOiD5kCwkq3o-deHzQFjSltOKTtrnuQ8Y4wlJupxc0YF5ayX_ND8upomsAXFCR1Xv8Rg0i3aTLarNwklyC4XEyygAaaYAHmYCtoglOROiMk7gkbYXKXccvQmFFNcDKju_D2m0iITRuRj-NYWSAs6xlzakkzIdzDKa9rcZvzT5tFkfIZn9-d58-X66vPl-_bm47sPl29vWssVLy1VoxD0ghmhJtaPlAs81hvwQVpjWd8rYrAUF6MdRD9IZbEASSwXVA6G9YqdNy9P7x5T_LlCLnpx2YKvzUBcsyaSEdkLpURF2Qm1KeacYNLH5JbqkSZY7ynoWd-loPcUNJa6plBVL-4LrMMC41_NH9sr8PoEQP3m5iDpbB1Um0eXahp6jO4_Bd78o7feBWeN_wG3kOe4plAd1ERnqrH-tA_CPgeEV3Vd7DfttbH9</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1731786996</pqid></control><display><type>article</type><title>Effect of pulmonary vascular resistance before left ventricular assist device implantation on short- and long-term post-transplant survival</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Tsukashita, Masaki, MD, PhD ; Takayama, Hiroo, MD, PhD ; Takeda, Koji, MD, PhD ; Han, Jiho, BS ; Colombo, Paolo C., MD ; Yuzefpolskaya, Melana, MD ; Topkara, Veli K., MD ; Garan, Arthur Reshad, MD ; Mancini, Donna M., MD ; Kurlansky, Paul A., MD ; Naka, Yoshifumi, MD, PhD</creator><creatorcontrib>Tsukashita, Masaki, MD, PhD ; Takayama, Hiroo, MD, PhD ; Takeda, Koji, MD, PhD ; Han, Jiho, BS ; Colombo, Paolo C., MD ; Yuzefpolskaya, Melana, MD ; Topkara, Veli K., MD ; Garan, Arthur Reshad, MD ; Mancini, Donna M., MD ; Kurlansky, Paul A., MD ; Naka, Yoshifumi, MD, PhD</creatorcontrib><description>Abstract Objectives Pulmonary hypertension is often considered a contraindication to orthotopic heart transplantation. Left ventricular assist device support may improve pulmonary hypertension by unloading the left ventricle, making patients eligible for transplantation. We sought to investigate the effect of continuous-flow left ventricular assist device support on pulmonary hypertension and compare post-transplantation outcomes in patients with preexisting pulmonary hypertension. Methods Between March 2004 and December 2013, 256 potential orthotopic heart transplantation candidates underwent continuous-flow left ventricular assist device implantation at Columbia University. Preimplantation right heart catheterization data were available for 227 patients. Patients were divided into 2 groups on the basis of preimplantation pulmonary vascular resistance: low (<5 Wood units) (n = 182) and high (≥5 Wood units) (n = 45). Postimplantation and post-transplantation outcomes were compared between the groups. Results Pulmonary vascular resistance in the high resistance group decreased significantly during left ventricular assist device support ( P < .001). Post-transplantation in-hospital mortality was significantly higher in patients with high vascular resistance ( P < .05). However, 3-year survival after transplantation was similar between groups (85.0% and 79.0% for low and high vascular resistance, respectively; P = .45). Conclusions Continuous-flow left ventricular assist device therapy reduced pulmonary vascular resistance. Subsequent orthotopic heart transplantation in patients with significantly elevated pulmonary vascular resistance resulted in higher in-hospital mortality but similar 3-year survival.</description><identifier>ISSN: 0022-5223</identifier><identifier>EISSN: 1097-685X</identifier><identifier>DOI: 10.1016/j.jtcvs.2015.07.012</identifier><identifier>PMID: 26253875</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Academic Medical Centers ; Adult ; Aged ; Cardiac Catheterization ; Cardiothoracic Surgery ; Female ; Heart Failure - diagnosis ; Heart Failure - mortality ; Heart Failure - physiopathology ; Heart Failure - therapy ; heart transplantation ; Heart Transplantation - adverse effects ; Heart Transplantation - mortality ; Heart-Assist Devices ; Hospital Mortality ; Humans ; Hypertension, Pulmonary - diagnosis ; Hypertension, Pulmonary - mortality ; Hypertension, Pulmonary - physiopathology ; Hypertension, Pulmonary - therapy ; Kaplan-Meier Estimate ; Male ; Middle Aged ; New York City ; Patient Selection ; Predictive Value of Tests ; Prosthesis Design ; Pulmonary Artery - physiopathology ; pulmonary hypertension ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome ; Vascular Resistance ; ventricular assist device ; Ventricular Function, Left</subject><ispartof>The Journal of thoracic and cardiovascular surgery, 2015-11, Vol.150 (5), p.1352-1361.e2</ispartof><rights>The American Association for Thoracic Surgery</rights><rights>2015 The American Association for Thoracic Surgery</rights><rights>Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c595t-29d66243a69f38d2560d9f3e5b7cac38891a0764dcb68b79c06e71c5627ba3893</citedby><cites>FETCH-LOGICAL-c595t-29d66243a69f38d2560d9f3e5b7cac38891a0764dcb68b79c06e71c5627ba3893</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022522315012222$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26253875$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tsukashita, Masaki, MD, PhD</creatorcontrib><creatorcontrib>Takayama, Hiroo, MD, PhD</creatorcontrib><creatorcontrib>Takeda, Koji, MD, PhD</creatorcontrib><creatorcontrib>Han, Jiho, BS</creatorcontrib><creatorcontrib>Colombo, Paolo C., MD</creatorcontrib><creatorcontrib>Yuzefpolskaya, Melana, MD</creatorcontrib><creatorcontrib>Topkara, Veli K., MD</creatorcontrib><creatorcontrib>Garan, Arthur Reshad, MD</creatorcontrib><creatorcontrib>Mancini, Donna M., MD</creatorcontrib><creatorcontrib>Kurlansky, Paul A., MD</creatorcontrib><creatorcontrib>Naka, Yoshifumi, MD, PhD</creatorcontrib><title>Effect of pulmonary vascular resistance before left ventricular assist device implantation on short- and long-term post-transplant survival</title><title>The Journal of thoracic and cardiovascular surgery</title><addtitle>J Thorac Cardiovasc Surg</addtitle><description>Abstract Objectives Pulmonary hypertension is often considered a contraindication to orthotopic heart transplantation. Left ventricular assist device support may improve pulmonary hypertension by unloading the left ventricle, making patients eligible for transplantation. We sought to investigate the effect of continuous-flow left ventricular assist device support on pulmonary hypertension and compare post-transplantation outcomes in patients with preexisting pulmonary hypertension. Methods Between March 2004 and December 2013, 256 potential orthotopic heart transplantation candidates underwent continuous-flow left ventricular assist device implantation at Columbia University. Preimplantation right heart catheterization data were available for 227 patients. Patients were divided into 2 groups on the basis of preimplantation pulmonary vascular resistance: low (<5 Wood units) (n = 182) and high (≥5 Wood units) (n = 45). Postimplantation and post-transplantation outcomes were compared between the groups. Results Pulmonary vascular resistance in the high resistance group decreased significantly during left ventricular assist device support ( P < .001). Post-transplantation in-hospital mortality was significantly higher in patients with high vascular resistance ( P < .05). However, 3-year survival after transplantation was similar between groups (85.0% and 79.0% for low and high vascular resistance, respectively; P = .45). Conclusions Continuous-flow left ventricular assist device therapy reduced pulmonary vascular resistance. Subsequent orthotopic heart transplantation in patients with significantly elevated pulmonary vascular resistance resulted in higher in-hospital mortality but similar 3-year survival.</description><subject>Academic Medical Centers</subject><subject>Adult</subject><subject>Aged</subject><subject>Cardiac Catheterization</subject><subject>Cardiothoracic Surgery</subject><subject>Female</subject><subject>Heart Failure - diagnosis</subject><subject>Heart Failure - mortality</subject><subject>Heart Failure - physiopathology</subject><subject>Heart Failure - therapy</subject><subject>heart transplantation</subject><subject>Heart Transplantation - adverse effects</subject><subject>Heart Transplantation - mortality</subject><subject>Heart-Assist Devices</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Hypertension, Pulmonary - diagnosis</subject><subject>Hypertension, Pulmonary - mortality</subject><subject>Hypertension, Pulmonary - physiopathology</subject><subject>Hypertension, Pulmonary - therapy</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>New York City</subject><subject>Patient Selection</subject><subject>Predictive Value of Tests</subject><subject>Prosthesis Design</subject><subject>Pulmonary Artery - physiopathology</subject><subject>pulmonary hypertension</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Vascular Resistance</subject><subject>ventricular assist device</subject><subject>Ventricular Function, Left</subject><issn>0022-5223</issn><issn>1097-685X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFks-O1SAUxhujca6jT2BiWLpp5c8AZaGJmcyoySQu1MQdofRUqRSuQJvMM_jS0rmjCzcSElj8Ps7h-07TPCe4I5iIV3M3F7vljmLCOyw7TOiD5kCwkq3o-deHzQFjSltOKTtrnuQ8Y4wlJupxc0YF5ayX_ND8upomsAXFCR1Xv8Rg0i3aTLarNwklyC4XEyygAaaYAHmYCtoglOROiMk7gkbYXKXccvQmFFNcDKju_D2m0iITRuRj-NYWSAs6xlzakkzIdzDKa9rcZvzT5tFkfIZn9-d58-X66vPl-_bm47sPl29vWssVLy1VoxD0ghmhJtaPlAs81hvwQVpjWd8rYrAUF6MdRD9IZbEASSwXVA6G9YqdNy9P7x5T_LlCLnpx2YKvzUBcsyaSEdkLpURF2Qm1KeacYNLH5JbqkSZY7ynoWd-loPcUNJa6plBVL-4LrMMC41_NH9sr8PoEQP3m5iDpbB1Um0eXahp6jO4_Bd78o7feBWeN_wG3kOe4plAd1ERnqrH-tA_CPgeEV3Vd7DfttbH9</recordid><startdate>20151101</startdate><enddate>20151101</enddate><creator>Tsukashita, Masaki, MD, PhD</creator><creator>Takayama, Hiroo, MD, PhD</creator><creator>Takeda, Koji, MD, PhD</creator><creator>Han, Jiho, BS</creator><creator>Colombo, Paolo C., MD</creator><creator>Yuzefpolskaya, Melana, MD</creator><creator>Topkara, Veli K., MD</creator><creator>Garan, Arthur Reshad, MD</creator><creator>Mancini, Donna M., MD</creator><creator>Kurlansky, Paul A., MD</creator><creator>Naka, Yoshifumi, MD, PhD</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20151101</creationdate><title>Effect of pulmonary vascular resistance before left ventricular assist device implantation on short- and long-term post-transplant survival</title><author>Tsukashita, Masaki, MD, PhD ; Takayama, Hiroo, MD, PhD ; Takeda, Koji, MD, PhD ; Han, Jiho, BS ; Colombo, Paolo C., MD ; Yuzefpolskaya, Melana, MD ; Topkara, Veli K., MD ; Garan, Arthur Reshad, MD ; Mancini, Donna M., MD ; Kurlansky, Paul A., MD ; Naka, Yoshifumi, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c595t-29d66243a69f38d2560d9f3e5b7cac38891a0764dcb68b79c06e71c5627ba3893</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Academic Medical Centers</topic><topic>Adult</topic><topic>Aged</topic><topic>Cardiac Catheterization</topic><topic>Cardiothoracic Surgery</topic><topic>Female</topic><topic>Heart Failure - diagnosis</topic><topic>Heart Failure - mortality</topic><topic>Heart Failure - physiopathology</topic><topic>Heart Failure - therapy</topic><topic>heart transplantation</topic><topic>Heart Transplantation - adverse effects</topic><topic>Heart Transplantation - mortality</topic><topic>Heart-Assist Devices</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Hypertension, Pulmonary - diagnosis</topic><topic>Hypertension, Pulmonary - mortality</topic><topic>Hypertension, Pulmonary - physiopathology</topic><topic>Hypertension, Pulmonary - therapy</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>New York City</topic><topic>Patient Selection</topic><topic>Predictive Value of Tests</topic><topic>Prosthesis Design</topic><topic>Pulmonary Artery - physiopathology</topic><topic>pulmonary hypertension</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Vascular Resistance</topic><topic>ventricular assist device</topic><topic>Ventricular Function, Left</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tsukashita, Masaki, MD, PhD</creatorcontrib><creatorcontrib>Takayama, Hiroo, MD, PhD</creatorcontrib><creatorcontrib>Takeda, Koji, MD, PhD</creatorcontrib><creatorcontrib>Han, Jiho, BS</creatorcontrib><creatorcontrib>Colombo, Paolo C., MD</creatorcontrib><creatorcontrib>Yuzefpolskaya, Melana, MD</creatorcontrib><creatorcontrib>Topkara, Veli K., MD</creatorcontrib><creatorcontrib>Garan, Arthur Reshad, MD</creatorcontrib><creatorcontrib>Mancini, Donna M., MD</creatorcontrib><creatorcontrib>Kurlansky, Paul A., MD</creatorcontrib><creatorcontrib>Naka, Yoshifumi, MD, PhD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tsukashita, Masaki, MD, PhD</au><au>Takayama, Hiroo, MD, PhD</au><au>Takeda, Koji, MD, PhD</au><au>Han, Jiho, BS</au><au>Colombo, Paolo C., MD</au><au>Yuzefpolskaya, Melana, MD</au><au>Topkara, Veli K., MD</au><au>Garan, Arthur Reshad, MD</au><au>Mancini, Donna M., MD</au><au>Kurlansky, Paul A., MD</au><au>Naka, Yoshifumi, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of pulmonary vascular resistance before left ventricular assist device implantation on short- and long-term post-transplant survival</atitle><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle><addtitle>J Thorac Cardiovasc Surg</addtitle><date>2015-11-01</date><risdate>2015</risdate><volume>150</volume><issue>5</issue><spage>1352</spage><epage>1361.e2</epage><pages>1352-1361.e2</pages><issn>0022-5223</issn><eissn>1097-685X</eissn><abstract>Abstract Objectives Pulmonary hypertension is often considered a contraindication to orthotopic heart transplantation. Left ventricular assist device support may improve pulmonary hypertension by unloading the left ventricle, making patients eligible for transplantation. We sought to investigate the effect of continuous-flow left ventricular assist device support on pulmonary hypertension and compare post-transplantation outcomes in patients with preexisting pulmonary hypertension. Methods Between March 2004 and December 2013, 256 potential orthotopic heart transplantation candidates underwent continuous-flow left ventricular assist device implantation at Columbia University. Preimplantation right heart catheterization data were available for 227 patients. Patients were divided into 2 groups on the basis of preimplantation pulmonary vascular resistance: low (<5 Wood units) (n = 182) and high (≥5 Wood units) (n = 45). Postimplantation and post-transplantation outcomes were compared between the groups. Results Pulmonary vascular resistance in the high resistance group decreased significantly during left ventricular assist device support ( P < .001). Post-transplantation in-hospital mortality was significantly higher in patients with high vascular resistance ( P < .05). However, 3-year survival after transplantation was similar between groups (85.0% and 79.0% for low and high vascular resistance, respectively; P = .45). Conclusions Continuous-flow left ventricular assist device therapy reduced pulmonary vascular resistance. Subsequent orthotopic heart transplantation in patients with significantly elevated pulmonary vascular resistance resulted in higher in-hospital mortality but similar 3-year survival.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26253875</pmid><doi>10.1016/j.jtcvs.2015.07.012</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Academic Medical Centers Adult Aged Cardiac Catheterization Cardiothoracic Surgery Female Heart Failure - diagnosis Heart Failure - mortality Heart Failure - physiopathology Heart Failure - therapy heart transplantation Heart Transplantation - adverse effects Heart Transplantation - mortality Heart-Assist Devices Hospital Mortality Humans Hypertension, Pulmonary - diagnosis Hypertension, Pulmonary - mortality Hypertension, Pulmonary - physiopathology Hypertension, Pulmonary - therapy Kaplan-Meier Estimate Male Middle Aged New York City Patient Selection Predictive Value of Tests Prosthesis Design Pulmonary Artery - physiopathology pulmonary hypertension Retrospective Studies Risk Assessment Risk Factors Time Factors Treatment Outcome Vascular Resistance ventricular assist device Ventricular Function, Left |
| title | Effect of pulmonary vascular resistance before left ventricular assist device implantation on short- and long-term post-transplant survival |
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