The 15th Annual Report from The Society of Thoracic Surgeons (STS) Interagency Registry for Mechanically Assisted Circulatory Support (Intermacs) includes 29,634 continuous-flow left ventricular assist devices (LVAD) from the 10-year period between 2014 through 2024. The outcomes reported here demonstrate continued improved survival in the current era of fully magnetically levitated (Mag-Lev) devices, with a significantly higher 1-year (85.7% versus 78.4%) and 5-year (59.7% versus 43.7%) survival than those receiving non-Mag-Lev devices. Mag-Lev recipients are experiencing a lower incidence of adverse events, including freedom from GI bleeding (72.6%), device malfunction (82.9%) and stroke (86.7%) at 5 years. Additionally, a focus on a subgroup of patients less than 50 years of age have demonstrated superior outcomes in both survival (91.6% survival at 1 year and 72.6% survival at 5 years) and decreased incidence of adverse events compared to older recipients. This younger cohort also demonstrated more tolerance to the characteristics of sex, race, ethnicity and psychosocial indicators that are associated with worse outcomes following heart transplantation (HT). Based upon these data, a potential net prolongation of life may be realized by considering prolonged LVAD support prior to HT in this population. These analyses provide preliminary data that could positively influence adoption of LVAD technology in groups previously not seen as candidates for this therapy, while providing a more responsible donor allocation strategy for advanced heart failure patients.
Copyright © 2024. Published by Elsevier Inc.