UCLA

Background: Prior studies have identified risk factors for survival in patients with end-stage heart failure (HF) requiring left ventricular assist device (LVAD) support. However, patients with biventricular HF may represent a unique cohort.

Methods: We retrospectively evaluated a consecutive cohort of 113 adult, end-stage HF patients at UCLA Medical Center who required BIVAD support between 2000 and 2009.

Results: Survival to transplant was 66.4%, with 1-year actuarial survival of 62.8%. All patients were INTERMACS level 1 or 2 and received Thoratec paracorporeal BIVAD as bridge-to-transplant. We generated a scoring system for survival to transplant. Our final model with age, gender, dialysis, cholesterol, ventilator, and albumin gave a c-statistic of 0.870. A simplified system preserved a c-statistic of 0.844. Patients were divided into normal or high risk groups (median survival of 367 and 17 days, respectively), with strong discrimination between groups for mortality. In this study, we generate a scoring system that offers high prognostic ability for patients requiring BIVAD support, in hopes that it may assist in clinical decision making. Further studies are needed to prospectively validate our scoring system.