Septuagenarian population has similar survival and outcomes to younger patients after left ventricular assist device implantation

Abstract

Background: Left ventricular assist device (LVAD) implantation may be an attractive alternative therapeutic option for elderly patients with heart failure who are ineligible for heart transplantation. Aim: We aimed to describe the characteristics and outcomes of elderly patients (i.e. aged ≥ 70 years) receiving an LVAD. Methods: This observational study was conducted in 19 centres between 2006 and 2016. Patients were divided into two groups–younger (aged < 70 years) and elderly (aged ≥ 70 years), based on age at time of LVAD implantation. Results: A total of 652 patients were included in the final analysis, and 74 patients (11.3%) were aged ≥ 70 years at the time of LVAD implantation (maximal age 77.6 years). The proportion of elderly patients receiving an LVAD each year was constant, with a median of 10.6% (interquartile range 8.0–15.4%) per year, and all were implanted as destination therapy. Elderly and younger patients had similar durations of hospitalization in intensive care units and total lengths of hospital stays. Both age groups experienced similar rates of LVAD-related complications (i.e. stroke, bleeding, driveline infection and LVAD exchange), and the occurrence of LVAD complications did not impact survival in the elderly group compared with the younger group. Lastly, when compared with younger patients implanted as destination therapy, the elderly group also exhibited similar mid-term survival. Conclusion: This work strongly suggests that selected elderly adults can be scheduled for LVAD implantation.