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Destination Therapy with Left Ventricular Assist Devices in Non-transplant Centres: The Time is Right.


ABSTRACT: For almost half a century, cardiac transplant has been the only long-term treatment for patients with end-stage heart failure. Implantable left ventricular assist devices (LVADs) have emerged as a new treatment option for advanced heart failure as destination therapy for patients either too old or not suitable for transplant. A meta-analysis presenting head-to-head comparisons of cardiac transplant versus LVAD as destination therapy (LVAD-DT) found no difference in 1-year mortality rates between LVAD-DT and cardiac transplant (OR 1.49; 95% CI [0.48-4.66]; I2=82.8%). Moreover, a recent subanalysis from the Interagency Registry for Mechanically Assisted Circulatory Support found similar outcomes after LVAD-DT implantation in both transplant and non-transplant centres. The time is right for LVAD-DT in non-transplant centres, provided multidisciplinary heart failure teams and expertise are in place.

SUBMITTER: Bayes-Genis A 

PROVIDER: S-EPMC7215475 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Destination Therapy with Left Ventricular Assist Devices in Non-transplant Centres: The Time is Right.

Bayes-Genis Antoni A   Muñoz-Guijosa Christian C   Santiago-Vacas Evelyn E   Montero Santiago S   García-García Cosme C   Codina Pau P   Núñez Julio J   Lupón Josep J  

European cardiology 20200201


For almost half a century, cardiac transplant has been the only long-term treatment for patients with end-stage heart failure. Implantable left ventricular assist devices (LVADs) have emerged as a new treatment option for advanced heart failure as destination therapy for patients either too old or not suitable for transplant. A meta-analysis presenting head-to-head comparisons of cardiac transplant versus LVAD as destination therapy (LVAD-DT) found no difference in 1-year mortality rates between  ...[more]

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