Circulatory support exceeding five years with a continuous-flow left ventricular assist device. Identification of positive predicators for a successful long-time VAD therapy

Objective: Continuous-flow left ventricular assist devices (CF-LVAD) are now allowing for years of safe circulatory support with enhanced quality of life. Our aim was to identify positive predicators for a successful longtime VAD therapy. Methods: We analysed retrospectively the data of our patients with end-stage cardiac failure based on dilative and ischemic cardiomyopathy who were on LVAD support for more than five years. Results: One patient continues with support at 7 years and 5 months and has decided to not undergo transplant. The two other patients have undergone heart transplant after support times of 5-years and 7 months and 5 years and 9 months. Few complications occurred and the patients had very active lifestyles during support. Explant analysis revealed very low bearing wear and minimal pannus. We were able to identify positive predicators for a successful long-time VAD therapy. Regular Monitoring of patients, increased compliance, low amount of infections, active lifestyle and well trained patients contribute to a long time durability of VAD therapy. Conclusion: LVADs have good clinical durability to over 5 years to provide long-term hemodynamic support options for patients with advanced heart failure. Comprehensive patient education, Patient compliance and careful monitoring for all adverse events are important contributions to safe long-term support.