The Annals of Thorcic Surgery
December 17, 2021
Twelfth Interagency Registry for Mechanically Assisted Circulatory Support Report: Readmissions after LVAD
Shah, P., Yuzefpolskaya, M., Hickey, G. W., Breathett, K., Wever-Pinzon, O., Khue-Ton, V., Hiesinger, W., Koehl, D., Kirklin, J. K., Cantor, R. S., Jacobs, J. P., Habib, R. H., Pagani, F. D., Goldstein, D. J.
The twelfth annual report from the Society of Thoracic Surgeons (STS) Interagency Registry for Mechanically Assisted Circulatory Support (Intermacs) highlights outcomes for 26,688 continuous-flow LVAD patients over the past decade (2011-2020). In 2020, we observed the largest drop in yearly LVAD implant volumes since the registry's inception, which reflects the effects of the COVID-19 pandemic on cardiac surgical volumes in the United States. The 2018 heart transplant allocation policy change in the U.S. continues to affect LVAD implantation volumes and device strategy, with 78.1% of patients now implanted as destination therapy. Despite an older and sicker patient cohort, survival in the recent era (2016-2020) at one- and two-years continues to improve at 82.8% and 74.1%. Patient adverse event profile has also improved in the recent era, with significant reductions in stroke, gastrointestinal bleeding, infection, and device malfunction/pump thrombosis. Finally, we review the burden of readmissions after LVAD implant and highlight an opportunity to improve patient outcomes by reducing this frequent and vexing problem.