Bridge from central extracorporeal life support is a risk factor of cerebrovascular accidents after durable left ventricular assist device implantation
A bridging strategy from extracorporeal life support (ECLS) is effective in salvage and a bridge to recovery or to a durable left ventricular assist device (LVAD) for acute refractory heart failure. However, the correlation of this strategy with adverse events after durable LVAD implantation has not...
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| Veröffentlicht in: | Journal of artificial organs 2022-09, Vol.25 (3), p.214-222 |
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| creator | Tonai, Kohei Fukushima, Satsuki Tadokoro, Naoki Kainuma, Satoshi Kawamoto, Naonori Kakuta, Takashi Koga-Ikuta, Ayumi Watanabe, Takuya Seguchi, Osamu Tsukamoto, Yasumasa Fukushima, Norihide Fujita, Tomoyuki |
| description | A bridging strategy from extracorporeal life support (ECLS) is effective in salvage and a bridge to recovery or to a durable left ventricular assist device (LVAD) for acute refractory heart failure. However, the correlation of this strategy with adverse events after durable LVAD implantation has not been fully investigated. This study enrolled 158 consecutive patients who had either the HeartMate II or HeartMate 3 and were implanted for bridge-to-transplantation. These devices were implanted as the primary mechanical support device in 115 patients, whereas the remaining 43 underwent LVAD implantation as the bridge from central ECLS. The primary study endpoint was all-cause mortality and cerebrovascular accidents (CVAs) after durable LVAD implantation, and the secondary endpoints were adverse events. Overall survival was not significantly different between the two groups. In contrast, the probability of CVAs was significantly greater in the bridge group than in the primary group (probability of CVAs,
P
= 0.002; log-rank test). In Cox multivariate logistic regression analysis, a bridge from central ECLS was an independent predictive factor of CVAs (hazard ratio 4.27, 95% confidence interval 1.43–12.8;
P
= 0.0095). Patients who are bridged from central ECLS are more frequently complicated by CVAs compared with those who undergo primary implantation of a durable LVAD, but survival is not significantly different between the two groups. A bridge from central ECLS is an independent predictive factor of CVAs post-implantation of an LVAD. |
| doi_str_mv | 10.1007/s10047-021-01303-2 |
| format | Article |
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P
= 0.002; log-rank test). In Cox multivariate logistic regression analysis, a bridge from central ECLS was an independent predictive factor of CVAs (hazard ratio 4.27, 95% confidence interval 1.43–12.8;
P
= 0.0095). Patients who are bridged from central ECLS are more frequently complicated by CVAs compared with those who undergo primary implantation of a durable LVAD, but survival is not significantly different between the two groups. A bridge from central ECLS is an independent predictive factor of CVAs post-implantation of an LVAD.</description><identifier>ISSN: 1434-7229</identifier><identifier>EISSN: 1619-0904</identifier><identifier>DOI: 10.1007/s10047-021-01303-2</identifier><identifier>PMID: 34866164</identifier><language>eng</language><publisher>Singapore: Springer Nature Singapore</publisher><subject>Biomedical Engineering and Bioengineering ; Cardiac Surgery ; Confidence intervals ; Congestive heart failure ; Extracorporeal Membrane Oxygenation ; Heart Failure ; Heart transplantation ; Heart-Assist Devices ; Humans ; Implantation ; Medicine ; Medicine & Public Health ; Nephrology ; Original ; Original Article ; Rank tests ; Regression analysis ; Retrospective Studies ; Risk analysis ; Risk Factors ; Statistical analysis ; Strategy ; Stroke ; Survival ; Transplantation ; Treatment Outcome ; Ventricle</subject><ispartof>Journal of artificial organs, 2022-09, Vol.25 (3), p.214-222</ispartof><rights>The Author(s) 2021</rights><rights>2021. The Author(s).</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c564t-af2dabaac2ea845a5a2dc974276be216a28d7c27c1c1e426b7924f5112dd90c33</citedby><cites>FETCH-LOGICAL-c564t-af2dabaac2ea845a5a2dc974276be216a28d7c27c1c1e426b7924f5112dd90c33</cites><orcidid>0000-0002-9481-8860</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10047-021-01303-2$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10047-021-01303-2$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34866164$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tonai, Kohei</creatorcontrib><creatorcontrib>Fukushima, Satsuki</creatorcontrib><creatorcontrib>Tadokoro, Naoki</creatorcontrib><creatorcontrib>Kainuma, Satoshi</creatorcontrib><creatorcontrib>Kawamoto, Naonori</creatorcontrib><creatorcontrib>Kakuta, Takashi</creatorcontrib><creatorcontrib>Koga-Ikuta, Ayumi</creatorcontrib><creatorcontrib>Watanabe, Takuya</creatorcontrib><creatorcontrib>Seguchi, Osamu</creatorcontrib><creatorcontrib>Tsukamoto, Yasumasa</creatorcontrib><creatorcontrib>Fukushima, Norihide</creatorcontrib><creatorcontrib>Fujita, Tomoyuki</creatorcontrib><title>Bridge from central extracorporeal life support is a risk factor of cerebrovascular accidents after durable left ventricular assist device implantation</title><title>Journal of artificial organs</title><addtitle>J Artif Organs</addtitle><addtitle>J Artif Organs</addtitle><description>A bridging strategy from extracorporeal life support (ECLS) is effective in salvage and a bridge to recovery or to a durable left ventricular assist device (LVAD) for acute refractory heart failure. However, the correlation of this strategy with adverse events after durable LVAD implantation has not been fully investigated. This study enrolled 158 consecutive patients who had either the HeartMate II or HeartMate 3 and were implanted for bridge-to-transplantation. These devices were implanted as the primary mechanical support device in 115 patients, whereas the remaining 43 underwent LVAD implantation as the bridge from central ECLS. The primary study endpoint was all-cause mortality and cerebrovascular accidents (CVAs) after durable LVAD implantation, and the secondary endpoints were adverse events. Overall survival was not significantly different between the two groups. In contrast, the probability of CVAs was significantly greater in the bridge group than in the primary group (probability of CVAs,
P
= 0.002; log-rank test). In Cox multivariate logistic regression analysis, a bridge from central ECLS was an independent predictive factor of CVAs (hazard ratio 4.27, 95% confidence interval 1.43–12.8;
P
= 0.0095). Patients who are bridged from central ECLS are more frequently complicated by CVAs compared with those who undergo primary implantation of a durable LVAD, but survival is not significantly different between the two groups. A bridge from central ECLS is an independent predictive factor of CVAs post-implantation of an LVAD.</description><subject>Biomedical Engineering and Bioengineering</subject><subject>Cardiac Surgery</subject><subject>Confidence intervals</subject><subject>Congestive heart failure</subject><subject>Extracorporeal Membrane Oxygenation</subject><subject>Heart Failure</subject><subject>Heart transplantation</subject><subject>Heart-Assist Devices</subject><subject>Humans</subject><subject>Implantation</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nephrology</subject><subject>Original</subject><subject>Original Article</subject><subject>Rank tests</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Statistical analysis</subject><subject>Strategy</subject><subject>Stroke</subject><subject>Survival</subject><subject>Transplantation</subject><subject>Treatment Outcome</subject><subject>Ventricle</subject><issn>1434-7229</issn><issn>1619-0904</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9kcuO1TAMhisEYoaBF2CBIrFhU0jctGk3SDDiJo3EBtaRmziHDG1TkvQInoTXJYdzGC4LNkksf_5t56-qh4I_FZyrZ6mcUtUcRM1Fw5sablXnohNDzQcub5e3bGStAIaz6l5K15wL1Sp-tzprZN91opPn1feX0dsdMRfDzAwtOeLE6Gu5TIhriFTCyTtiaVtLmJlPDFn06TNzaHKILLhSF2mMYY_JbBNGhsZ4W7QK6jJFZreI40RsIpfZ_tDEn8CUfMrM0t4bYn5eJ1wyZh-W-9Udh1OiB6f7ovr4-tWHy7f11fs37y5fXNWm7WSu0YHFEdEAYS9bbBGsGZQE1Y0EokPorTKgjDCCJHSjGkC6VgiwduCmaS6q50fddRtnsqcf0Gv0M8ZvOqDXf2cW_0nvwl4PUvS8F0XgyUkghi8bpaxnnwxNZRMKW9LQcdVwxdVQ0Mf_oNdhi0tZT0MBANTQHyaCI2ViSCmSuxlGcH3wXR9918V3_dN3DaXo0Z9r3JT8MroAzRFIJbXsKP7u_R_ZH35pvZo</recordid><startdate>20220901</startdate><enddate>20220901</enddate><creator>Tonai, Kohei</creator><creator>Fukushima, Satsuki</creator><creator>Tadokoro, Naoki</creator><creator>Kainuma, Satoshi</creator><creator>Kawamoto, Naonori</creator><creator>Kakuta, Takashi</creator><creator>Koga-Ikuta, Ayumi</creator><creator>Watanabe, Takuya</creator><creator>Seguchi, Osamu</creator><creator>Tsukamoto, Yasumasa</creator><creator>Fukushima, Norihide</creator><creator>Fujita, Tomoyuki</creator><general>Springer Nature Singapore</general><general>Springer Nature B.V</general><scope>C6C</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>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-9481-8860</orcidid></search><sort><creationdate>20220901</creationdate><title>Bridge from central extracorporeal life support is a risk factor of cerebrovascular accidents after durable left ventricular assist device implantation</title><author>Tonai, Kohei ; Fukushima, Satsuki ; Tadokoro, Naoki ; Kainuma, Satoshi ; Kawamoto, Naonori ; Kakuta, Takashi ; Koga-Ikuta, Ayumi ; Watanabe, Takuya ; Seguchi, Osamu ; Tsukamoto, Yasumasa ; Fukushima, Norihide ; Fujita, Tomoyuki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c564t-af2dabaac2ea845a5a2dc974276be216a28d7c27c1c1e426b7924f5112dd90c33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Biomedical Engineering and Bioengineering</topic><topic>Cardiac Surgery</topic><topic>Confidence intervals</topic><topic>Congestive heart failure</topic><topic>Extracorporeal Membrane Oxygenation</topic><topic>Heart Failure</topic><topic>Heart transplantation</topic><topic>Heart-Assist Devices</topic><topic>Humans</topic><topic>Implantation</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nephrology</topic><topic>Original</topic><topic>Original Article</topic><topic>Rank tests</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>Statistical analysis</topic><topic>Strategy</topic><topic>Stroke</topic><topic>Survival</topic><topic>Transplantation</topic><topic>Treatment Outcome</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tonai, Kohei</creatorcontrib><creatorcontrib>Fukushima, Satsuki</creatorcontrib><creatorcontrib>Tadokoro, Naoki</creatorcontrib><creatorcontrib>Kainuma, Satoshi</creatorcontrib><creatorcontrib>Kawamoto, Naonori</creatorcontrib><creatorcontrib>Kakuta, Takashi</creatorcontrib><creatorcontrib>Koga-Ikuta, Ayumi</creatorcontrib><creatorcontrib>Watanabe, Takuya</creatorcontrib><creatorcontrib>Seguchi, Osamu</creatorcontrib><creatorcontrib>Tsukamoto, Yasumasa</creatorcontrib><creatorcontrib>Fukushima, Norihide</creatorcontrib><creatorcontrib>Fujita, Tomoyuki</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of artificial organs</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tonai, Kohei</au><au>Fukushima, Satsuki</au><au>Tadokoro, Naoki</au><au>Kainuma, Satoshi</au><au>Kawamoto, Naonori</au><au>Kakuta, Takashi</au><au>Koga-Ikuta, Ayumi</au><au>Watanabe, Takuya</au><au>Seguchi, Osamu</au><au>Tsukamoto, Yasumasa</au><au>Fukushima, Norihide</au><au>Fujita, Tomoyuki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bridge from central extracorporeal life support is a risk factor of cerebrovascular accidents after durable left ventricular assist device implantation</atitle><jtitle>Journal of artificial organs</jtitle><stitle>J Artif Organs</stitle><addtitle>J Artif Organs</addtitle><date>2022-09-01</date><risdate>2022</risdate><volume>25</volume><issue>3</issue><spage>214</spage><epage>222</epage><pages>214-222</pages><issn>1434-7229</issn><eissn>1619-0904</eissn><abstract>A bridging strategy from extracorporeal life support (ECLS) is effective in salvage and a bridge to recovery or to a durable left ventricular assist device (LVAD) for acute refractory heart failure. However, the correlation of this strategy with adverse events after durable LVAD implantation has not been fully investigated. This study enrolled 158 consecutive patients who had either the HeartMate II or HeartMate 3 and were implanted for bridge-to-transplantation. These devices were implanted as the primary mechanical support device in 115 patients, whereas the remaining 43 underwent LVAD implantation as the bridge from central ECLS. The primary study endpoint was all-cause mortality and cerebrovascular accidents (CVAs) after durable LVAD implantation, and the secondary endpoints were adverse events. Overall survival was not significantly different between the two groups. In contrast, the probability of CVAs was significantly greater in the bridge group than in the primary group (probability of CVAs,
P
= 0.002; log-rank test). In Cox multivariate logistic regression analysis, a bridge from central ECLS was an independent predictive factor of CVAs (hazard ratio 4.27, 95% confidence interval 1.43–12.8;
P
= 0.0095). Patients who are bridged from central ECLS are more frequently complicated by CVAs compared with those who undergo primary implantation of a durable LVAD, but survival is not significantly different between the two groups. A bridge from central ECLS is an independent predictive factor of CVAs post-implantation of an LVAD.</abstract><cop>Singapore</cop><pub>Springer Nature Singapore</pub><pmid>34866164</pmid><doi>10.1007/s10047-021-01303-2</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-9481-8860</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of artificial organs, 2022-09, Vol.25 (3), p.214-222 |
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| language | eng |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Biomedical Engineering and Bioengineering Cardiac Surgery Confidence intervals Congestive heart failure Extracorporeal Membrane Oxygenation Heart Failure Heart transplantation Heart-Assist Devices Humans Implantation Medicine Medicine & Public Health Nephrology Original Original Article Rank tests Regression analysis Retrospective Studies Risk analysis Risk Factors Statistical analysis Strategy Stroke Survival Transplantation Treatment Outcome Ventricle |
| title | Bridge from central extracorporeal life support is a risk factor of cerebrovascular accidents after durable left ventricular assist device implantation |
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