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Fully magnetically centrifugal left ventricular assist device and long-term outcomes: the ELEVATE registry

医学 队列 植入 目的地治疗 生活质量(医疗保健) 不利影响 心室辅助装置 人口统计学的 队列研究 内科学 外科 心力衰竭 人口学 社会学 护理部
作者
Jan D. Schmitto,Steven M. Shaw,Jens Garbade,Finn Gustafsson,Michiel Morshuis,Daniel Zimpfer,Jacob Lavee,Yuriy Pya,Michael Berchtold‐Herz,AiJia Wang,Carlo Gazzola,Evgenij Potapov,Diyar Saeed
出处
期刊:European Heart Journal [Oxford University Press]
标识
DOI:10.1093/eurheartj/ehad658
摘要

HeartMate 3 (HM3) is a fully magnetically levitated continuous flow left ventricular assist device, which received CE marking in 2015. The ELEVATE Registry was initiated to collect real-world outcomes in patients treated with HM3 post-CE Mark approval.A total of 540 subjects implanted at 26 centres between March 2015 and February 2017 were included in this registry. Of these, 463 received the device as a primary implant (primary implant cohort, PIC), 19 as a pump exchange (pump exchange cohort), and in 58 patients, only anonymized survival data were collected (anonymized cohort, AC). Patients in the PIC contributed to the baseline demographics, survival, adverse events, quality of life (QoL) (EuroQoL-5 Dimensions-5 Levels visual analogue scale), and functional capacity (6 min walk distance) assessments, while patients in the AC contributed only to survival.Primary implant cohort patients had a mean age of 56 years and were predominantly male (89%) with 48% ischaemic aetiology. The majority of subjects was designated bridge to transplant (66%) and had INTERMACS Profiles 1-3 (70%). At baseline, the subjects had poor functional capacity (104 ± 140 m) and impaired QoL (35 ± 19 points). The overall survival rate of the PIC was 63.3% and survival free of stroke was 58.1% at 5 years. Significant improvements in functional capacity and QoL were observed and maintained for 5 years (301 ± 131 m and 64 ± 20 points, respectively).Real-world data from the ELEVATE registry demonstrate an overall survival rate for primary implants of 63.3%. In the PIC, reductions in adverse events for patients in the extended follow-up and improved QoL and functional capacity were observed at 5 years in this patient population with advanced heart failure.
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