Heart failure & cardiomyopathiesCohort study
Incidence, Outcomes, and Opportunity for Left Ventricular Assist Device Weaning for Myocardial Recovery
- Retrospective registry cohort study
- UNOS registry
- national
Authors' conclusion
In the United States, LVAD explant for myocardial recovery was underutilized, leading to a very low incidence at the national level despite a realistic rate being achieved in designated centers for selected patients. With follow-up extending up to 4 years after explant, more than one-half were successfully removed and stayed off the waitlist, and approximately 70% were free from heart failure relapse events.
Study context
- Population
- Left ventricular assist device (LVAD) implants in the US, 2005–2020 (UNOS registry)
- Participants
- 15,728 LVAD implants
- Outcome
- Incidence of LVAD explant for myocardial recovery and subsequent HF relapse (relisting followed by delisting due to death, being too ill or transplantation; or second durable LVAD implant)
Main finding
As reported in the abstract
- Patients explanted for recovery
- 126
- Implanting centres performing explant for recovery
- 55 (38%) of 145
- Crude cumulative incidence of explant for recovery at 2 years
- 0.7%
- Incidence among designated centres in selected young nonischaemic cohort
- 4.7%
- Explanted patients subsequently delisted for sustained recovery
- 76 (60%)
- 30-day incidence of HF relapse
- 6% (7 of 126)
- Freedom from HF relapse at 4 years
- 72.5%
Observational data: associations, not effects.
Original publication
Incidence, Outcomes, and Opportunity for Left Ventricular Assist Device Weaning for Myocardial Recovery. JACC Heart Fail. Published 24 January 2024. doi:10.1016/j.jchf.2023.12.006
Summarised from the published abstract; every number is checked against it