000075639 001__ 75639
000075639 005__ 20200103141020.0
000075639 0247_ $$2doi$$a10.1002/ejhf.956
000075639 0248_ $$2sideral$$a104657
000075639 037__ $$aART-2018-104657
000075639 041__ $$aeng
000075639 100__ $$aBarge-Caballero, E.
000075639 245__ $$aClinical outcomes of temporary mechanical circulatory support as a direct bridge to heart transplantation: a nationwide Spanish registry
000075639 260__ $$c2018
000075639 5060_ $$aAccess copy available to the general public$$fUnrestricted
000075639 5203_ $$aBackground: In Spain, listing for high-urgent heart transplantation is allowed for critically ill candidates not weanable from temporary mechanical circulatory support (T-MCS). We sought to analyse the clinical outcomes of this strategy.
Methods and results: We conducted a case-by-case, retrospective review of clinical records of 291 adult patients listed for high-urgent heart transplantation under temporary devices from 2010 to 2015 in 16 Spanish institutions. Survival after listing and adverse clinical events were studied. At the time of listing, 169 (58%) patients were supported on veno-arterial extracorporeal membrane oxygenation (VA-ECMO), 70 (24%) on temporary left ventricular assist devices (T-LVAD) and 52 (18%) on temporary biventricular assist devices (T-BiVAD). Seven patients transitioned from VA-ECMO to temporary ventricular assist devices while on the waiting list. Mean time on T-MCS was 13.1 ± 12.6 days. Mean time from listing to transplantation was 7.6 ± 8.5 days. Overall, 230 (79%) patients were transplanted and 54 (18.6%) died during MCS. In-hospital postoperative mortality after transplantation was 33.3%, 11.9% and 26.2% for patients bridged on VA-ECMO, T-LVAD and T-BiVAD, respectively (P = 0.008). Overall survival from listing to hospital discharge was 54.4%, 78.6% and 55.8%, respectively (P = 0.002). T-LVAD support was independently associated with a lower risk of death over the first year after listing (hazard ratio 0.52, 95% confidence interval 0.30–0.92). Patients treated with VA-ECMO showed the highest incidence rate of adverse clinical events associated with T-MCS.
Conclusion: Temporary devices may be used to bridge critically ill candidates directly to heart transplantation in a setting of short waiting list times, as is the case of Spain. In our series, bridging with T-LVAD was associated with more favourable outcomes than bridging with T-BiVAD or VA-ECMO.
000075639 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc-nd$$uhttp://creativecommons.org/licenses/by-nc-nd/3.0/es/
000075639 590__ $$a13.965$$b2018
000075639 591__ $$aCARDIAC & CARDIOVASCULAR SYSTEMS$$b6 / 136 = 0.044$$c2018$$dQ1$$eT1
000075639 592__ $$a5.537$$b2018
000075639 593__ $$aCardiology and Cardiovascular Medicine$$c2018$$dQ1
000075639 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000075639 700__ $$aAlmenar-Bonet, L.
000075639 700__ $$aGonzalez-Vilchez, F.
000075639 700__ $$aLambert-Rodríguez, J.L.
000075639 700__ $$aGonzález-Costello, J.
000075639 700__ $$aSegovia-Cubero, J.
000075639 700__ $$aCastel-Lavilla, M.A.
000075639 700__ $$aDelgado-Jiménez, J.
000075639 700__ $$aGarrido-Bravo, I.P.
000075639 700__ $$aRangel-Sousa, D.
000075639 700__ $$aMartínez-Sellés, M.
000075639 700__ $$aDe la Fuente-Galan, L.
000075639 700__ $$aRábago-Juan-Aracil, G.
000075639 700__ $$aSanz-Julve, M.$$uUniversidad de Zaragoza
000075639 700__ $$aHervás-Sotomayor, D.
000075639 700__ $$aMirabet-Pérez, S.
000075639 700__ $$aMuñiz, J.
000075639 700__ $$aCrespo-Leiro, M.G.
000075639 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000075639 773__ $$g20, 1 (2018), 178-186$$pEur. j. heart fail.$$tEuropean Journal of Heart Failure$$x1388-9842
000075639 8564_ $$s230360$$uhttps://zaguan.unizar.es/record/75639/files/texto_completo.pdf$$yVersión publicada
000075639 8564_ $$s110178$$uhttps://zaguan.unizar.es/record/75639/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000075639 909CO $$ooai:zaguan.unizar.es:75639$$particulos$$pdriver
000075639 951__ $$a2020-01-03-14:01:12
000075639 980__ $$aARTICLE