Advanced heart failure (HF) remains associated with substantial morbidity and mortality, particularly among patients who are not eligible for cardiac transplantation (CTx).
A retrospective analysis published in the Heart, Lung, and Circulation evaluated outcomes among VAD recipients treated at a statewide advanced HF centre between 2012 and 2024. Data collected included patient and device characteristics, right-sided heart catheterization indices, quality-of-life measures, and survival outcomes. A total of 18 patients were included in the analysis. The median Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile at implantation was 2 (interquartile range [IQR] 1.25–3).
The median survival from discharge was 5.9 years (IQR 4.1–8.3). Symptom burden improved at 6 months (p=0.00016). Quality-of-life measures improved through 12 months, including Kansas City Cardiomyopathy Questionnaire (KCCQ) scores (p=0.0042), EuroQol-5 Dimensions-5 Levels (EQ-5D-5L) scores (p=0.01), and Depression in the Medically Ill (DMI) screening scores (p=0.017). Functional capacity improved, with 6-minute walk distance (6MWD) increasing from 247.7±149.8 m to 526.9±165.5 m (p=0.003).
Hemodynamic parameters improved after implantation, including mean pulmonary artery pressure (36.6±10.8 to 26.1±14.4 mmHg; p=0.04), pulmonary capillary wedge pressure (25.3±7.6 to 14.1±9.1 mmHg; p=0.02), and cardiac output (3.5±1.3 to 5.5±1.2 L/min; p=0.0005).
Overall, DT-VAD implantation was associated with improvements in survival, hemodynamic, functional capacity, and quality-of-life measures in transplant-ineligible patients with advanced HF.