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Gómez-Bueno M, Pérez de la Sota E, Forteza Gil A, Ortiz-Berbel D, Castrodeza J, García-Cosío Carmena MD, Barge-Caballero E, Rangel Sousa D, Díaz Molina B, Manrique Antón R, Almenar-Bonet L, Uribarri González A, Barrio-Rodríguez A, Castel Lavilla MÁ, López-López L, Dobarro Pérez D, Pastor Pérez F, Burgos-Palacios V, Álvarez-García J, Garrido-Jiménez JM, González-Fernández Ó, Codina P, López-Granados A, Grau-Sepulveda A, González-Costello J. Durable ventricular assist device in Spain (2007-2020). First report of the REGALAD registry. Rev Esp Cardiol (Engl Ed) 2023; 76:227-237. [PMID: 36055642 DOI: 10.1016/j.rec.2022.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 07/06/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION AND OBJECTIVES This report presents the clinical characteristics, outcomes and complications of all consecutive patients implanted with a long-term mechanical circulatory support device in Spain between 2007 and 2020. METHODS Analysis of the Spanish Registry of durable ventricular assist devices (REGALAD) including data form Spanish centers with a mechanical circulatory support program. RESULTS During the study period, 263 ventricular assist devices were implanted in 22 hospitals. The implanted device was an isolated continuous-flow left ventricular assist device in 182 patients (69%), a pulsatile-flow device (58 isolated left ventricular and 21 biventricular) in 79 (30%), and a total artificial heart in 2 patients (1%). The strategy of the implant was as bridge to heart transplant in 78 patients (30%), bridge to candidacy in 110 (42%), bridge to recovery in 3 (1%) and destination therapy in 72 patients (27%). Overall survival at 6, 12 and 24 months was 79%, 74% and 69%, respectively, and was better in continuous-flow left ventricular assist devices (84%, 80%, and 75%). The main adverse events related to this therapy were infections (37% of patients), bleeding (35%), neurological (29%), and device malfunction (17%). CONCLUSIONS Durable ventricular assist devices have emerged in Spain in the last few years as a useful therapy for patients with advanced heart failure. As in other international registries, the current trend is to use continuous-flow intracorporeal left ventricular devices, which are associated with better results. Adverse events continue to be frequent and severe.
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Affiliation(s)
- Manuel Gómez-Bueno
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro-Majadahonda, Instituto de Investigación Sanitaria Puerta de Hierro-Segovia Arana (IDIPHISA), Majadahonda, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain.
| | | | - Alberto Forteza Gil
- Servicio de Cirugía Cardiaca, Hospital Universitario Puerta de Hierro-Majadahonda, Instituto de Investigación Sanitaria Puerta de Hierro-Segovia Arana (IDIPHISA), Majadahonda, Madrid, Spain
| | - Daniel Ortiz-Berbel
- Servicio de Cirugía Cardiaca, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Javier Castrodeza
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | - María Dolores García-Cosío Carmena
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital 12 de Octubre, Instituto de Investigación Sanitaria (imas12), Madrid, Spain
| | - Eduardo Barge-Caballero
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña (CHUAC), Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain
| | - Diego Rangel Sousa
- Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - Beatriz Díaz Molina
- Servicio de Cardiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Rebeca Manrique Antón
- Servicio de Cirugía Cardiaca, Clínica Universidad de Navarra, Pamplona, Navarra, Spain
| | - Luis Almenar-Bonet
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | | | - María Ángeles Castel Lavilla
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Laura López-López
- Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - David Dobarro Pérez
- Servicio de Cardiología, Hospital Álvaro Cunqueiro, Complexo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain
| | - Francisco Pastor Pérez
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | - Virginia Burgos-Palacios
- Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
| | - Jesús Álvarez-García
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | | | - Pau Codina
- Servicio de Cardiología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | | | - Andrés Grau-Sepulveda
- Servicio de Cardiología, Hospital Universitario Son Espases, Palma, Balearic Islands, Spain
| | - José González-Costello
- Servicio de Cardiología, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
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Gómez-Bueno M, Pérez de la Sota E, Forteza Gil A, Ortiz-Berbel D, Castrodeza J, García-Cosío Carmena MD, Barge-Caballero E, Rangel Sousa D, Díaz Molina B, Manrique Antón R, Almenar-Bonet L, Uribarri González A, Barrio-Rodríguez A, Castel Lavilla MÁ, López-López L, Dobarro Pérez D, Pastor Pérez F, Burgos-Palacios V, Álvarez-García J, Garrido-Jiménez JM, González-Fernández Ó, Codina P, López-Granados A, Grau-Sepulveda A, González-Costello J. Asistencia ventricular de larga duración en España (2007-2020). I informe del registro REGALAD. Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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de la Torre-Hernández JM, Garcia-Camarero T, Burgos-Palacios V, Ruiz-Lera M, Llano-Cardenal M, Exposito V, Sainz-Laso F, Lee DH, Figueroa A, Zueco J. Impact of drug eluting stents on the clinical practice of revascularisation of coronary artery disease. EUROINTERVENTION 2009; 5:460-4. [PMID: 19755334 DOI: 10.4244/eijv5i4a73] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS Drug-eluting stents (DES) have shown to reduce restenosis rates in all lesional subsets. This has expanded the application of percutaneous intervention (PCI). In this study we address the impact of the high DES penetration on the management of patients referred for coronary angiography. METHODS AND RESULTS We have studied the cohorts of patients referred for coronary angiography in 2000-2001 prior to DES availability, and in 2005-2006 with a 73% DES implementation. In 2000-1 of 2,458 coronary angiographic studies, 84% had significant lesions (>50%), 56% had PCI, 8.8% had CABG and in 443 (18%) with significant lesions no revascularisation was attempted. In 2005-6 out of 2,600 angiographies, 84% had significant lesions, 64% had PCI, 6% had CABG and in 312 (12%) with significant lesions no revascularisation was done. The increase in PCI, the reduction in CABG and the decrease in non-revascularised diseased cases were all significant (p<0,001). The PCI and CABG groups in 2005-6 compared to 2000-1 had a more complex lesion profile with, however, less in-stent restenotic lesions treated (10% vs 4.2%; p<0.001). CONCLUSIONS The wide clinical introduction of DES was associated with a significant increase in patients undergoing any kind of revascularisation, increasing the PCI volume to the detriment of CABG activity. Patients with PCI in 2006 had more complex lesions treated, whereas restenosis was less frequent.
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Affiliation(s)
- José M de la Torre-Hernández
- Unidad de Hemodinámica y Cardiología Intervencionista, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
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