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Does Small Size Matter With Continuous Flow Devices? : Analysis of the INTERMACS Database of Adults With BSA ≤1.5 m2

Wednesday, February 15, 2017

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Source

Source Name: JACC: Heart Failure

Author(s)

Farhan Zafar, MD, Chet R. Villa, MD, David L. Morales, MD, Elizabeth D. Blume, MD, David N. Rosenthal, MD, James K. Kirklin, MD, Angela Lorts, MD

The authors reviewed the retrospective INTERMACS database to assess whether outcomes after continuous-flow (CF) LVAD implantation varied with patient BSA.  A total of over 10,000 CF LVAD patients were included.  Of these, 231 (2%) had a BSA < 1.5 m².  

Outcomes:  Survival was similar.  Postoepratively, smaller patients had a higher incidence of bleeding and driveline infection, but a lower incidence of RV failure and renal dysfunction.

Comments

Study apparently seems to have limitations in terms of including patients with BSA< 1.5m2 , as small sized individuals usually compulsively repaced with smaller devices preferably and the results can't be compared technically to larger BSA individuals who seem to have greater cardiac inndex requiremnets in the setting of endstage heart failure. Secondly insignificantly smaller (n) representation of smaller BSA pts in the study raises questions as to speciifically attributed results to smaller pts like bleeding, infection and better RV and renal functions However very useful information regarding the devices with smaller sizes has been catered for ; same goes to the endeavur taken out by Researchers to highight a newer aspect of VADs

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