Outcomes of Left Ventricular Assist Devices as Destination Therapy: A Systematic Review with Meta-Analysis
Background: Heart failure (HF) is a chronic condition that significantly affects morbidity and mortality. For patients with end-stage HF who are not candidates for heart transplantation, left ventricular assist devices (LVADs) provide mechanical circulatory support as a long-term solution, known as...
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MDPI AG
2025-01-01
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| author | Emad Ali Al Khoufi |
| author_facet | Emad Ali Al Khoufi |
| author_sort | Emad Ali Al Khoufi |
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| description | Background: Heart failure (HF) is a chronic condition that significantly affects morbidity and mortality. For patients with end-stage HF who are not candidates for heart transplantation, left ventricular assist devices (LVADs) provide mechanical circulatory support as a long-term solution, known as destination therapy (DT). Objective: This meta-analysis aims to synthesize evidence on the survival rates, complications, and quality-of-life improvements associated with LVADs used as destination therapy in patients with end-stage HF. Methods: A systematic search of databases, including PubMed, Embase, Cochrane Library, Web of Science, and Scopus, was conducted to identify relevant studies. Studies were selected based on predefined inclusion and exclusion criteria. Data from 12 studies were extracted and analyzed using a random-effects model. Survival rates, complications (e.g., infection and bleeding), and quality-of-life measures were the primary outcomes evaluated. Results: The analysis showed significant improvements in survival, with a pooled effect size of 0.848 (95% CI: 0.306–1.390, <i>p</i> = 0.002). Complication rates varied, with infections and bleeding being the most common adverse events. Quality of life also improved significantly post-LVAD implantation, with a standardized mean difference of 0.78 (95% CI: 0.65–0.91). Conclusions: LVADs as destination therapy provide a viable option for improving the survival and quality of life of end-stage HF patients, despite the associated risks of complications. Further research is needed to refine patient selection and management strategies to optimize outcomes. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
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| spelling | doaj-art-a7fde238e5b84cdabaec02201a2fdbbf2025-01-24T13:38:35ZengMDPI AGLife2075-17292025-01-011515310.3390/life15010053Outcomes of Left Ventricular Assist Devices as Destination Therapy: A Systematic Review with Meta-AnalysisEmad Ali Al Khoufi0Internal Medicine Department, College of Medicine, King Faisal University, Al-Ahsa 31982, Saudi ArabiaBackground: Heart failure (HF) is a chronic condition that significantly affects morbidity and mortality. For patients with end-stage HF who are not candidates for heart transplantation, left ventricular assist devices (LVADs) provide mechanical circulatory support as a long-term solution, known as destination therapy (DT). Objective: This meta-analysis aims to synthesize evidence on the survival rates, complications, and quality-of-life improvements associated with LVADs used as destination therapy in patients with end-stage HF. Methods: A systematic search of databases, including PubMed, Embase, Cochrane Library, Web of Science, and Scopus, was conducted to identify relevant studies. Studies were selected based on predefined inclusion and exclusion criteria. Data from 12 studies were extracted and analyzed using a random-effects model. Survival rates, complications (e.g., infection and bleeding), and quality-of-life measures were the primary outcomes evaluated. Results: The analysis showed significant improvements in survival, with a pooled effect size of 0.848 (95% CI: 0.306–1.390, <i>p</i> = 0.002). Complication rates varied, with infections and bleeding being the most common adverse events. Quality of life also improved significantly post-LVAD implantation, with a standardized mean difference of 0.78 (95% CI: 0.65–0.91). Conclusions: LVADs as destination therapy provide a viable option for improving the survival and quality of life of end-stage HF patients, despite the associated risks of complications. Further research is needed to refine patient selection and management strategies to optimize outcomes.https://www.mdpi.com/2075-1729/15/1/53left ventricular assist deviceheart failuredestination therapysurvival ratequality of life |
| spellingShingle | Emad Ali Al Khoufi Outcomes of Left Ventricular Assist Devices as Destination Therapy: A Systematic Review with Meta-Analysis Life left ventricular assist device heart failure destination therapy survival rate quality of life |
| title | Outcomes of Left Ventricular Assist Devices as Destination Therapy: A Systematic Review with Meta-Analysis |
| title_full | Outcomes of Left Ventricular Assist Devices as Destination Therapy: A Systematic Review with Meta-Analysis |
| title_fullStr | Outcomes of Left Ventricular Assist Devices as Destination Therapy: A Systematic Review with Meta-Analysis |
| title_full_unstemmed | Outcomes of Left Ventricular Assist Devices as Destination Therapy: A Systematic Review with Meta-Analysis |
| title_short | Outcomes of Left Ventricular Assist Devices as Destination Therapy: A Systematic Review with Meta-Analysis |
| title_sort | outcomes of left ventricular assist devices as destination therapy a systematic review with meta analysis |
| topic | left ventricular assist device heart failure destination therapy survival rate quality of life |
| url | https://www.mdpi.com/2075-1729/15/1/53 |
| work_keys_str_mv | AT emadalialkhoufi outcomesofleftventricularassistdevicesasdestinationtherapyasystematicreviewwithmetaanalysis |