The European Registry for Patients with Mechanical Circulatory Support of the European Association for Cardio-Thoracic Surgery: third report
De By T.M.M.H. Schoenrath F. Veen K.M. Mohacsi P. Stein J. Alkhamees K.M.M. Anastasiadis K. Berhnardt A. Beyersdorf F. Caliskan K. Reineke D. Damman K. Fiane A. Gkouziouta A. Gollmann-Tepeköylü C. Gustafsson F. Hulman M. Iacovoni A. Loforte A. Merkely B. Musumeci F. Němec P. Netuka I. Özbaran M. Potapov E. Pya Y. Rábago G. Ramjankhan F. Reichenspurner H. Saeed D. Sandoval E. Stockman B. Vanderheyden M. Tops L. Wahlers T. Zembala M. Zimpfer D. Carrel T. Gummert J. Meyns B.
1 July 2022European Association for Cardio-Thoracic Surgery
European Journal of Cardio-thoracic Surgery
2022#62Issue 1
OBJECTIVES: In the third report of the European Registry for Patients with Mechanical Circulatory Support of the European Association for Cardio-Thoracic Surgery, outcomes of patients receiving mechanical circulatory support are reviewed in relation to implant era. METHODS: Procedures in adult patients (January 2011-June 2020) were included. Patients from centres with <60% follow-ups completed were excluded. Outcomes were stratified into 3 eras (2011-2013, 2014-2017 and 2018-2020). Adverse event rates (AERs) were calculated and stratified into early phase (<3 months) and late phase (>3 months). Risk factors for death were explored using univariable Cox regression with a stepwise time-varying hazard ratio (<3 vs >3 months). RESULTS: In total, 4834 procedures in 4486 individual patients (72 hospitals) were included, with a median follow-up of 1.1 (interquartile range: 0.3-2.6) years. The annual number of implants (range: 346-600) did not significantly change (P = 0.41). Both Interagency Registry for Mechanically Assisted Circulatory Support class (classes 4-7: 23, 25 and 33%; P < 0.001) and in-hospital deaths (18.5, 17.2 and 11.2; P < 0.001) decreased significantly between eras. Overall, mortality, transplants and the probability of weaning were 55, 25 and 2% at 5 years after the implant, respectively. Major infections were mainly noted early after the implant occurred (AER<3 months: 1.44 vs AER>3 months: 0.45). Bilirubin and creatinine levels were significant risk factors in the early phase but not in the late phase after the implant. CONCLUSIONS: In its 10 years of existence, EUROMACS has become a point of reference enabling benchmarking and outcome monitoring. Patient characteristics and outcomes changed between implant eras. In addition, both occurrence of outcomes and risk factor weights are time dependent.
End-stage heart failure , Mechanical circulatory support , Registry , Ventricular assist device
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Euromacs, Eacts House, Windsor, United Kingdom
Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
Dzhk (German Centre for Cardiovascular Research), Partner Site, Berlin, Germany
Thorax Center, Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands
HerzZentrum Hirslanden, Zürich, Switzerland
Prince Sultan Cardiac Center Al Hassa, Saudi Arabia
Cardiothoracic Dept, Ahepa University Hospital, Aristotle University, Thessaloniki, Greece
Center for Cardiovascular Surgery and Transplantation Surgery Brno, Brno, Czech Republic
Department of Cardiovascular Surgery, University Hospital Freiburg, Freiburg, Germany
Medical Faculty of the Albert-Ludwigs-University, Freiburg, Germany
University Hospital Bern, Bern, Switzerland
Universitair Medisch Centrum Groningen, Groningen, Netherlands
Rikshospitalet, Oslo, Norway
Onassis Cardiac Surgery Center, Athens, Greece
Universitätskliniken Innsbruck, Innsbruck, Austria
Rigshospitalet, Copenhagen, Denmark
Klinika Kardiochirurgie Nusch, Bratislava, Slovakia
Ospedale Papa Giovanni Xiii, Bergamo, Italy
San Orsola Hospital, Bologna, Italy
Heart Center of the Semmelweis University, Budapest, Hungary
Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy
Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
Ege University Hospital, Izmir, Turkey
National Research Cardiac Surgery Center, Astana, Kazakhstan
Clinica Universidad de Navarra, Pamplona, Spain
Utrecht University Medical Center, Utrecht, Netherlands
Universitäres Herzzentrum Hamburg, Hamburg, Germany
Herzzentrum Leipzig, Leipzig, Germany
Espamacs, Sociedad Española de Cirugía Cardiovascular y Endovascular (SECCE), Madrid, Spain
Onze Lieve Vrouwenziekenhuis, Aalst, Belgium
Leiden University Medical Center, Leiden, Netherlands
Universitätsklinikum Köln AöR, Köln, Germany
Silesian Center for Heart Diseases, Zabrze, Poland
Vienna Medical University, Vienna, Austria
University Hospital Zürich, Zürich, Switzerland
Herz- und Diabeteszentrum Nrw, Bad Oeynhausen, Germany
Katholieke Universiteit Leuven, Leuven, Belgium
Euromacs
Department of Cardiothoracic and Vascular Surgery
Dzhk (German Centre for Cardiovascular Research)
Thorax Center
HerzZentrum Hirslanden
Prince Sultan Cardiac Center Al Hassa
Cardiothoracic Dept
Center for Cardiovascular Surgery and Transplantation Surgery Brno
Department of Cardiovascular Surgery
Medical Faculty of the Albert-Ludwigs-University
University Hospital Bern
Universitair Medisch Centrum Groningen
Rikshospitalet
Onassis Cardiac Surgery Center
Universitätskliniken Innsbruck
Rigshospitalet
Klinika Kardiochirurgie Nusch
Ospedale Papa Giovanni Xiii
San Orsola Hospital
Heart Center of the Semmelweis University
Azienda Ospedaliera San Camillo-Forlanini
Institute for Clinical and Experimental Medicine (IKEM)
Ege University Hospital
National Research Cardiac Surgery Center
Clinica Universidad de Navarra
Utrecht University Medical Center
Universitäres Herzzentrum Hamburg
Herzzentrum Leipzig
Espamacs
Onze Lieve Vrouwenziekenhuis
Leiden University Medical Center
Universitätsklinikum Köln AöR
Silesian Center for Heart Diseases
Vienna Medical University
University Hospital Zürich
Herz- und Diabeteszentrum Nrw
Katholieke Universiteit Leuven
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