TY - JOUR
T1 - Quality of life with an implanted left ventricular assist device
AU - Moskowitz, Alan J.
AU - Weinberg, Alan D.
AU - Oz, Mehmet C.
AU - Williams, Deborah L.
N1 - Funding Information:
Doctor Moskowitz was supported, in part, by a research grant from the Morris W. Stroud III Program on Scientific Approaches to Quality of Life in Health and Aging, Center for Geriatrics and Gerontology, College of Physicians & Surgeons, Columbia University.
Funding Information:
Doctor Oz was supported, in part, by an award from the Irving Center for Clinical Research at Columbia-Presbyterian Medical Center and holds the Irving Assistant Professorship of Surgery.
PY - 1997/12
Y1 - 1997/12
N2 - Background. With the increasing use of left ventricular assist devices (LVADs) for longer-term support of patients awaiting cardiac transplantation, we must now consider whether to use these devices as alternatives to medical therapy when biologic hearts are needed but not forthcoming. This expansion of use depends as much on quality of life as it does on survival. To draw an inference about long-term quality of life with implanted LVADs, we studied 'bridged' patients at our institution. Methods. We elicited, by standard gamble, the utilities (preferences) of bridged patients at three points in their care: before LVAD implantation, during LVAD support, and after cardiac transplantation. Results. Utility was 0.548 (±0.276) before implantation, 0.809 (±0.136) during LVAD support, and 0.964 (±0.089) after transplantation. For patients interviewed during all three states of health, the utilities were significantly different (p = 0.0009 by analysis of variance). Conclusions. The quality of life with an LVAD was substantially better than with medical therapy, on par with renal transplantation (as established by others), and not as good as after cardiac transplantation. These results portend an acceptable quality of life for long-term use of LVADs for patients with end-stage heart failure and contribute to the growing body of evidence supporting a clinical trial to test this new use.
AB - Background. With the increasing use of left ventricular assist devices (LVADs) for longer-term support of patients awaiting cardiac transplantation, we must now consider whether to use these devices as alternatives to medical therapy when biologic hearts are needed but not forthcoming. This expansion of use depends as much on quality of life as it does on survival. To draw an inference about long-term quality of life with implanted LVADs, we studied 'bridged' patients at our institution. Methods. We elicited, by standard gamble, the utilities (preferences) of bridged patients at three points in their care: before LVAD implantation, during LVAD support, and after cardiac transplantation. Results. Utility was 0.548 (±0.276) before implantation, 0.809 (±0.136) during LVAD support, and 0.964 (±0.089) after transplantation. For patients interviewed during all three states of health, the utilities were significantly different (p = 0.0009 by analysis of variance). Conclusions. The quality of life with an LVAD was substantially better than with medical therapy, on par with renal transplantation (as established by others), and not as good as after cardiac transplantation. These results portend an acceptable quality of life for long-term use of LVADs for patients with end-stage heart failure and contribute to the growing body of evidence supporting a clinical trial to test this new use.
UR - http://www.scopus.com/inward/record.url?scp=0031415550&partnerID=8YFLogxK
U2 - 10.1016/S0003-4975(97)01000-X
DO - 10.1016/S0003-4975(97)01000-X
M3 - Article
C2 - 9436569
AN - SCOPUS:0031415550
SN - 0003-4975
VL - 64
SP - 1764
EP - 1769
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 6
ER -