Twelve-month follow-up after implantation of a centrifugal-flow left ventricular assist device

Aim. To study hemodynamic changes according to transthoracic echocardiography, heart failure (HF) course, quality of life (QOL) of patients, complications and mortality within 12 months after implantation of a left ventricular assist device (LVAD).

Material and methods. The study included 53 patients with endstage HF who met the criteria for LVAD implantation. Group 1 included 23 patients who underwent implantation, while group 2 included 30 patients who refused the intervention. At baseline, before discharge, and after 3, 6, and 12 months, the following were performed: transthoracic echocardiography, 6-minute walk test, assessment of HF class, quality of life, N-terminal pro-brain natriuretic peptide, hospitalization rate, complications, and fatal outcomes.

Results. Mortality in group 1 was 30,4%, and in group 2 — 30,0%. The following complications of LVAD implantation were recorded: right ventricular failure — 13, gastrointestinal bleeding — 3, ventricular tachycardia — 4, LVAD-associated infection — 14 cases. Unlike group 2, in group 1, we recorded decrease of LV end-diastolic dimension from 7,4 [7,1; 8,0] to 6,4 [5,7; 6,9] cm (p<0,001), mitral regurgitation from 2,2±0,54 to 1,44±0,4 st, (p<0,001), N-terminal pro-brain natriuretic peptide from 2239 [1623; 4057] to 740 [438.5; 1273] pg/ml (p<0,001), as well as improvement of HF class (p<0,001), and lower hospitalization rate — 23 vs 37 (p=0,014).

Conclusion. In the present study, LVAD implantation improved intracardiac hemodynamics, HF class, quality of life, as well as decreased the hospitalization and HF decompensation rates, but not a mortality.

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