부산대학교 도서관

Introduction: There is limited data examining predictors of outcome in patients with HeartMate 3 (HM3) LVAD. We sought to examine factors that predict pump replacement and death in patients with HM3 LVAD.Hypothesis: Traditional risk factors in older LVAD models may be unassociated with pump replacement and death in patients with HM3 LVAD.Methods: Patients that underwent HM3 LVAD implantation from 2015 to 2020 were identified from a single tertiary care center. Records were reviewed for demographic/clinical characteristics at LVAD implantation and a primary outcome of LVAD replacement or death. Predictors of outcome were identified using univariable Cox regression. Kaplan Meier (KM) analysis and log-rank test were used to assess outcome-free survival based on pre-operative BMI and albumin.Results: A total of 298 patients that met inclusion criteria were identified. Over a median follow-up of 2.3 years, 97 patients (33%) experienced a primary outcome. Predictors of outcome included age, peripheral vascular disease, ECMO prior to LVAD implantation, and pre-operative creatinine and albumin levels. BMI was not predictive of the primary outcome (Table 1). Outcome-free survival was different among patients with and without pre-operative hypoalbuminemia, but unassociated with differences in BMI (Figure 1).Conclusions: This is one of the largest single-institution cohorts that has examined predictors of adverse outcomes in patients with HM3 LVAD. Optimizing pre-operative nutrition (as reflected by albumin) may help prevent adverse outcomes in this population. Lastly, HM3 LVAD may be a safe option in obese patients who would otherwise not be candidates for transplantation.