Open AccessDestination Therapy with Left Ventricular Assist Devices in Non-transplant Centres: The Time is Right
Author(s) -
Antoni BayésGenís,
Christian Muñoz-Guijosa,
Evelyn SantiagoVacas,
Santiago Montero,
Cosme García-García,
Pau Codina,
Julio Núñez,
Josep Lupón
Publication year - 2020
Publication title -
european cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.864
H-Index - 12
eISSN - 1758-3764
pISSN - 1758-3756
DOI - 10.15420/ecr.2019.29.2
Subject(s) - left and right , medicine , cardiology , destination therapy , right to left , ventricular assist device , computer science , engineering , heart failure , operating system , structural engineering
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.