TY - JOUR
T1 - Impact of gender in patients with continuous-flow left ventricular assist device therapy in end-stage heart failure
AU - Zubarevich, Alina
AU - Szczechowicz, Marcin
AU - Osswald, Anja
AU - Arjomandi Rad, Arian
AU - Vardanyan, Robert
AU - Pompeu Bo Sá, Michel
AU - Van den Eynde, Jef
AU - Schmack, Bastian
AU - Wendt, Daniel
AU - Koch, Achim
AU - Pizanis, Nikolaus
AU - Kamler, Markus
AU - Ruhparwar, Arjang
AU - Weymann, Alexander
AU - Zhigalov, Konstantin
PY - 2021/12
Y1 - 2021/12
N2 - BACKGROUND: There is an ongoing debate about the influence of the female gender on postoperative outcomes after durable left ventricular assist device (LVAD) implantation. Despite the differences in pathophysiology of heart failure in females, therapy concepts are the same as in the male population. The aim of this study was to investigate the role of the female gender in surgical heart failure therapy.MATERIALS AND METHODS: Between August 2010 and January 2020, 207 patients were treated with durable LVAD at out institution. We matched 111 patients in two groups to compare the outcomes in male and female patients and to stratify the risk factors of mortality.RESULTS: The groups were matched 2:1 and were comparable after matching. We found no difference in in-hospital and follow-up mortality between male and female patients. Postoperative adverse events and complications were found to be unvaried across male and female patients. Female patients had higher rates of postoperative LVAD-thrombosis compared to their male counterparts (13.5% vs 0, p = 0.001) and the rates of renal replacement therapy lasting over 90 days were also higher in the female group (33.8% vs 56.8%, p = 0.021). Furthermore, the female gender was not an independent predictor neither of in-hospital nor follow-up mortality.CONCLUSIONS: Durable continuous flow left ventricular assist devices as a bridge to transplantation or recovery in female patients are associated with a higher risk of acute kidney injury requiring RRT and are at a higher risk of LVAD-thrombosis. Nevertheless, survival rates between genders are similar.
AB - BACKGROUND: There is an ongoing debate about the influence of the female gender on postoperative outcomes after durable left ventricular assist device (LVAD) implantation. Despite the differences in pathophysiology of heart failure in females, therapy concepts are the same as in the male population. The aim of this study was to investigate the role of the female gender in surgical heart failure therapy.MATERIALS AND METHODS: Between August 2010 and January 2020, 207 patients were treated with durable LVAD at out institution. We matched 111 patients in two groups to compare the outcomes in male and female patients and to stratify the risk factors of mortality.RESULTS: The groups were matched 2:1 and were comparable after matching. We found no difference in in-hospital and follow-up mortality between male and female patients. Postoperative adverse events and complications were found to be unvaried across male and female patients. Female patients had higher rates of postoperative LVAD-thrombosis compared to their male counterparts (13.5% vs 0, p = 0.001) and the rates of renal replacement therapy lasting over 90 days were also higher in the female group (33.8% vs 56.8%, p = 0.021). Furthermore, the female gender was not an independent predictor neither of in-hospital nor follow-up mortality.CONCLUSIONS: Durable continuous flow left ventricular assist devices as a bridge to transplantation or recovery in female patients are associated with a higher risk of acute kidney injury requiring RRT and are at a higher risk of LVAD-thrombosis. Nevertheless, survival rates between genders are similar.
KW - Female
KW - Heart Failure/therapy
KW - Heart Transplantation
KW - Heart-Assist Devices
KW - Humans
KW - Male
KW - Retrospective Studies
KW - Sex Factors
KW - Survival Rate
KW - Treatment Outcome
U2 - 10.1177/03913988211006715
DO - 10.1177/03913988211006715
M3 - Article
C2 - 33784845
SN - 0391-3988
VL - 44
SP - 990
EP - 997
JO - International Journal of Artificial Organs
JF - International Journal of Artificial Organs
IS - 12
ER -