Current results of left ventricular assist device therapy in France: the ASSIST-ICD registry - Université Paris-Est-Créteil-Val-de-Marne Access content directly
Journal Articles European Journal of Cardio-Thoracic Surgery Year : 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 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
4 Institut Coeur Poumon [CHU Lille]
5 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
6 Hôpital Haut-Lévêque [CHU Bordeaux]
7 Université de Bordeaux Ségalen [Bordeaux 2]
8 HUS - Les Hôpitaux Universitaires de Strasbourg
9 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
10 CHU Montpellier
11 UM - Université de Montpellier
12 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
13 Hôpital Michallon
14 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
15 TIMONE - Hôpital de la Timone [CHU - APHM]
16 Hôpital Louis Pradel [CHU - HCL]
17 Hôpital Charles Nicolle [Rouen]
18 UNICAEN - Université de Caen Normandie
19 CHU Caen
20 CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
21 Pôle des Cardiopathies Congénitales du Nouveau-Né à L'adulte - Centre Constitutif Cardiopathies Congénitales Complexes M3C, Groupe Hospitalier Paris Saint-Joseph, Hôpital Marie-Lannelongue, Inserm U999, Université Paris-Saclay
22 Hôpital Marie-Lannelongue
23 UP11 - Université Paris-Sud - Paris 11
24 CHU Henri Mondor [Créteil]
25 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
26 CHU Clermont-Ferrand
27 HEGP - Hôpital Européen Georges Pompidou [APHP]
28 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
Aude Boignard
  • Function : Author
Nicolas D’ostrevy
  • Function : Author
  • PersonId : 1345629
  • IdHAL : ndostrevy
Benjamin Duband

Abstract

Abstract 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 and versions

hal-04395005 , version 1 (30-05-2024)

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Amedeo Anselmi, Vincent Galand, André Vincentelli, Stéphane Boule, 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-04395005⟩
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