MCS REGISTRY in ADULTS – EUROMACS, JMACS, and INTERMACSGender differences and outcomes in left ventricular assist device support: The European Registry for Patients with Mechanical Circulatory Support
Section snippets
Study population
Between January 2011 and June 2014, 966 patients were prospectively enrolled into EUROMACS, an online database collecting anonymized data of demographics, device implantation, and long-term follow-up of patients with ventricular support.10 At the present time, more than 50 European and non-European centers from 15 countries are involved. Preimplantation data regarding patient characteristics, social situation, HF medication at admission, preoperative blood values, primary cardiac diagnosis, and
Gender-specific preoperative characteristics
Selected baseline characteristics of the study sample are presented in Table 1 (for further baseline characteristics see Table S1a; missing value information is provided in Table S1b, available in the online version of this article at www.jhltonline.org). Patients (n = 966) (median age 55 years, 151 [15.6%] women, 84% European origin) underwent primary ventricular support (LVAD, n = 790; BIVAD, n = 52; LVAD with temporary RVAD, n = 99; isolated RVAD, n = 10; total artificial heart, n = 15).
Discussion
We demonstrated significant gender differences not only in the perioperative period but also in the long-term course after VAD implantation. Women were shown to receive less VAD support despite a more critical HF state at admission. Both genders differed for implanted device types with implantation of smaller device pumps in women. Women required temporary or permanent RV support more often due to a higher incidence of RV failure. Overall survival in women was significantly worse.
In contrast to
Disclosure statement
H.R. is a consultant for HeartWare. None of the other authors has a financial relationship with a commercial entity that has an interest in the subject of the presented manuscript or other conflicts of interest to disclose.
EUROMACS is a committee of the European Association of Cardiothoracic Surgery (EACTS). Its foundation was financially supported by “Friede Springer Herzstiftung.”
We thank Roland Hetzer and Jan Gummert and the 15 other founding international members for their initiative in
References (23)
- et al.
Effect of gender on bridging to transplantation and posttransplantation survival in patients with left ventricular assist devices
J Thorac Cardiovasc Surg
(2004) - et al.
Comparison of outcomes in women versus men using a continuous-flow left ventricular assist device as a bridge to transplantation
J Heart Lung Transplant
(2011) - et al.
An examination of survival by sex and race in the HeartWare Ventricular Assist Device for the Treatment of Advanced Heart Failure (ADVANCE) Bridge to Transplant (BTT) and continued access protocol trials
J Heart Lung Transplant
(2015) - et al.
HeartWare and HeartMate II left ventricular assist devices as bridge to transplantation: a comparative analysis
Ann Thorac Surg
(2014) - et al.
Gender differences in the risk of stroke during support with continuous-flow left ventricular assist device
J Heart Lung Transplant
(2015) - et al.
INTERMACS database for durable devices for circulatory support: first annual report
J Heart Lung Transplant
(2008) - et al.
Clinical characteristics of patients in studies of left ventricular dysfunction (SOLVD)
Am J Cardiol
(1992) - et al.
Pre-operative risk factors of bleeding and stroke during left ventricular assist device support: an analysis of more than 900 HeartMate II outpatients
J Am Coll Cardiol
(2014) - et al.
Early post-operative ventricular arrhythmias in patients with continuous-flow left ventricular assist devices
J Heart Lung Transplant
(2015) - et al.
The HVAD left ventricular assist device: risk factors for neurological events and risk mitigation strategies.
JACC Heart Fail
(2015)
Sixth INTERMACS annual report: a 10,000-patient database
J Heart Lung Transplant
Cited by (89)
Sex differences in heart transplantation - analysis of the national inpatient sample 2012-2019
2024, Current Problems in CardiologyAdverse events after left ventricular assist device implantation linked to psychosocial risk in women and men
2023, Journal of Heart and Lung TransplantationSex-Related Differences in Patient Characteristics, Hemodynamics, and Outcomes of Cardiogenic Shock: INOVA-SHOCK Registry
2023, Journal of the Society for Cardiovascular Angiography and Interventions
- 1
These authors have contributed equally to this work.