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Article Dans Une Revue European Journal of Cardio-Thoracic Surgery Année : 2020

Current results of left ventricular assist device therapy in France: the ASSIST-ICD registry

1 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
2 LTSI - Laboratoire Traitement du Signal et de l'Image
3 Institut Coeur Poumon [CHU Lille]
4 HUS - Les Hôpitaux Universitaires de Strasbourg
5 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
6 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
7 Service de chirurgie thoracique et cardio-vasculaire
8 UM - Université de Montpellier
9 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
10 Hôpital Michallon
11 Clinique de chirurgie cardiaque
12 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
13 TIMONE - Hôpital de la Timone [CHU - APHM]
14 Hôpital Louis Pradel [CHU - HCL]
15 Service de Cardiologie [CHU Rouen]
16 Hôpital Charles Nicolle [Rouen]
17 Service de chirurgie cadiovasculaire et thoracique [Rouen]
18 CHU Caen
19 CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
20 HPPIT - Hypertension pulmonaire : physiopathologie et innovation thérapeutique
21 UP11 - Université Paris-Sud - Paris 11
22 Hôpital Henri Mondor
23 CHU Henri Mondor [Créteil]
24 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
25 CHU Clermont-Ferrand
26 HEGP - Hôpital Européen Georges Pompidou [APHP]
27 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
28 Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes]
Camille Dambrin
  • Fonction : Auteur
Clément Delmas
Laurent Barandon
  • Fonction : Auteur
  • PersonId : 872953
Mathieu Pernot
Aude Boignard
  • Fonction : Auteur
Gerard Babatasi
  • Fonction : Auteur
Annette Belin
  • Fonction : Auteur
Nicolas Lellouche
  • Fonction : Auteur
  • PersonId : 764872
  • IdRef : 075154625
Nicolas d'Ostrevy
  • Fonction : Auteur
  • PersonId : 1345629
  • IdHAL : ndostrevy
Benjamin Duband

Résumé

OBJECTIVES: Our goal was to provide a picture of left ventricular assist device (LVAD) activity in France between 2007 and 2016 based on the multicentric ASSIST-ICD registry.METHODS: We retrospectively collected 136 variables including in-hospital data, follow-up survival rates and adverse events from 671 LVAD recipients at 20 out of 24 LVAD implant centres in France. The average follow-up time was 1.2 years (standard deviation: 1.4); the total follow-up time was 807.5 patient-years.RESULTS: The included devices were the HeartMate II®, HeartWare LVAS® or Jarvik 2000®. The overall likelihood of being alive while on LVAD support or having a transplant (primary end point) at 1, 2, 3 and 5 years postimplantation was 65.2%, 59.7%, 55.9% and 47.7%, respectively, given a cumulative incidence of 29.2% of receiving a transplant at year 5. At implantation, 21.5% of patients were on extracorporeal life support. The overall rate of cardiogenic shock at implantation was 53%. The major complications were driveline infection (26.1%), pump pocket or cannula infection (12.6%), LVAD thrombosis (12.2%), ischaemic (12.8%) or haemorrhagic stroke (5.4%; all strokes 18.2%), non-cerebral haemorrhage (9.1%) and LVAD exchange (5.2%). The primary end point (survival) was stratified by age at surgery and by the type of device used, with inference from baseline profiles. The primary end point combined with an absence of complications (secondary end point) was also stratified by device type.CONCLUSIONS: The ASSIST-ICD registry provides a real-life picture of LVAD use in 20 of the 24 implant centres in France. Despite older average age and a higher proportion of patients chosen for destination therapy, survival rates improved compared to those in previous national registry results. This LVAD registry contrasts with other international registries because patients with implants have more severe disease, and the national policy for graft attribution is distinct. We recommend referring patients for LVAD earlier and suggest a discussion of the optimal timing of a transplant for bridged patients (more dismal results after the second year of support?).
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Dates et versions

hal-02545980 , version 1 (10-06-2020)

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Amedeo Anselmi, Vincent Galand, André Vincentelli, Stéphane Boulé, Camille Dambrin, et al.. Current results of left ventricular assist device therapy in France: the ASSIST-ICD registry. European Journal of Cardio-Thoracic Surgery, 2020, 58 (1), pp.112-120. ⟨10.1093/ejcts/ezaa055⟩. ⟨hal-02545980⟩
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