Left Ventricular Assist Device Implantation in Cancer-Therapy-Related Heart Failure
Objectives: Cancer-therapy-related heart failure (CTrHF) due to cardiotoxic drugs or radiation is a growing cause of end-stage heart failure. Limited knowledge is available concerning the use of continuous-flow left-ventricular-assist devices (cfLVAD) in this setting. Methods: The files of all 1334...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-09-01
|
| Series: | Life |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-1729/12/10/1485 |
| _version_ | 1827649371966013440 |
|---|---|
| author | Johanna Mulzer Marcus Müller Felix Schoenrath Volkmar Falk Evgenij Potapov Jan Knierim |
| author_facet | Johanna Mulzer Marcus Müller Felix Schoenrath Volkmar Falk Evgenij Potapov Jan Knierim |
| author_sort | Johanna Mulzer |
| collection | DOAJ |
| description | Objectives: Cancer-therapy-related heart failure (CTrHF) due to cardiotoxic drugs or radiation is a growing cause of end-stage heart failure. Limited knowledge is available concerning the use of continuous-flow left-ventricular-assist devices (cfLVAD) in this setting. Methods: The files of all 1334 patients who underwent cfLVAD implantation between December 2008 and December 2020 were screened for the cause of heart failure. All patients with CTrHF were included in the analysis. Results: A total of 32 patients with a median age of 58 years (IQR: 46–65) were included in the study; 15 (47%) were male. The median time from the first diagnosis of heart failure (HF) to cfLVAD implantation was 6 months (IQR 2–24), and from cancer treatment to cfLVAD implantation 40 months (IQR 5–144). Malignancies comprised non-Hodgkin lymphoma (n = 12, 37%), breast cancer (n = 9, 28%), sarcoma (n = 5, 16%), leukemia (n = 5, 16%), and others (n = 1, 3%). In 24 patients, chemotherapy included anthracyclines (others n = 2, unknown n = 6). Chest radiation was performed in 13 patients (39%). Moreover, 71% were classified as INTERMACS profile 1 or 2. The 30-day survival rate after LVAD implantation was 88%. Rethoracotomy was necessary in nine (29%), and a temporary right ventricular assist device in seven (21%) patients. The median survival was 29 months. There was no significant difference in survival or right HF between patients with CTrHF and a matched control group. Conclusions: CfLVAD implantation is feasible in high-risk patients with CTrHF with or without prior chest radiation. |
| first_indexed | 2024-03-09T19:56:25Z |
| format | Article |
| id | doaj.art-488992c91e1f4063ad613b9db07663b8 |
| institution | Directory Open Access Journal |
| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-09T19:56:25Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Life |
| spelling | doaj.art-488992c91e1f4063ad613b9db07663b82023-11-24T00:55:40ZengMDPI AGLife2075-17292022-09-011210148510.3390/life12101485Left Ventricular Assist Device Implantation in Cancer-Therapy-Related Heart FailureJohanna Mulzer0Marcus Müller1Felix Schoenrath2Volkmar Falk3Evgenij Potapov4Jan Knierim5German Heart Center Berlin, Department of Cardiothoracic and Vascular Surgery, 13353 Berlin, GermanyGerman Heart Center Berlin, Department of Cardiothoracic and Vascular Surgery, 13353 Berlin, GermanyGerman Heart Center Berlin, Department of Cardiothoracic and Vascular Surgery, 13353 Berlin, GermanyGerman Heart Center Berlin, Department of Cardiothoracic and Vascular Surgery, 13353 Berlin, GermanyGerman Heart Center Berlin, Department of Cardiothoracic and Vascular Surgery, 13353 Berlin, GermanyGerman Heart Center Berlin, Department of Cardiothoracic and Vascular Surgery, 13353 Berlin, GermanyObjectives: Cancer-therapy-related heart failure (CTrHF) due to cardiotoxic drugs or radiation is a growing cause of end-stage heart failure. Limited knowledge is available concerning the use of continuous-flow left-ventricular-assist devices (cfLVAD) in this setting. Methods: The files of all 1334 patients who underwent cfLVAD implantation between December 2008 and December 2020 were screened for the cause of heart failure. All patients with CTrHF were included in the analysis. Results: A total of 32 patients with a median age of 58 years (IQR: 46–65) were included in the study; 15 (47%) were male. The median time from the first diagnosis of heart failure (HF) to cfLVAD implantation was 6 months (IQR 2–24), and from cancer treatment to cfLVAD implantation 40 months (IQR 5–144). Malignancies comprised non-Hodgkin lymphoma (n = 12, 37%), breast cancer (n = 9, 28%), sarcoma (n = 5, 16%), leukemia (n = 5, 16%), and others (n = 1, 3%). In 24 patients, chemotherapy included anthracyclines (others n = 2, unknown n = 6). Chest radiation was performed in 13 patients (39%). Moreover, 71% were classified as INTERMACS profile 1 or 2. The 30-day survival rate after LVAD implantation was 88%. Rethoracotomy was necessary in nine (29%), and a temporary right ventricular assist device in seven (21%) patients. The median survival was 29 months. There was no significant difference in survival or right HF between patients with CTrHF and a matched control group. Conclusions: CfLVAD implantation is feasible in high-risk patients with CTrHF with or without prior chest radiation.https://www.mdpi.com/2075-1729/12/10/1485assist deviceLVAD cancerchemotherapyradiationheart failure |
| spellingShingle | Johanna Mulzer Marcus Müller Felix Schoenrath Volkmar Falk Evgenij Potapov Jan Knierim Left Ventricular Assist Device Implantation in Cancer-Therapy-Related Heart Failure Life assist device LVAD cancer chemotherapy radiation heart failure |
| title | Left Ventricular Assist Device Implantation in Cancer-Therapy-Related Heart Failure |
| title_full | Left Ventricular Assist Device Implantation in Cancer-Therapy-Related Heart Failure |
| title_fullStr | Left Ventricular Assist Device Implantation in Cancer-Therapy-Related Heart Failure |
| title_full_unstemmed | Left Ventricular Assist Device Implantation in Cancer-Therapy-Related Heart Failure |
| title_short | Left Ventricular Assist Device Implantation in Cancer-Therapy-Related Heart Failure |
| title_sort | left ventricular assist device implantation in cancer therapy related heart failure |
| topic | assist device LVAD cancer chemotherapy radiation heart failure |
| url | https://www.mdpi.com/2075-1729/12/10/1485 |
| work_keys_str_mv | AT johannamulzer leftventricularassistdeviceimplantationincancertherapyrelatedheartfailure AT marcusmuller leftventricularassistdeviceimplantationincancertherapyrelatedheartfailure AT felixschoenrath leftventricularassistdeviceimplantationincancertherapyrelatedheartfailure AT volkmarfalk leftventricularassistdeviceimplantationincancertherapyrelatedheartfailure AT evgenijpotapov leftventricularassistdeviceimplantationincancertherapyrelatedheartfailure AT janknierim leftventricularassistdeviceimplantationincancertherapyrelatedheartfailure |