Nandini Nair, M.D., Ph.D., Texas Tech Health Sciences Center, Lubbock, TX, USA
Objectives: To assess the utility of permanent left ventricular assist devices (LVADS) in patients aged > 80 years.
Background: The gold standard for advanced heart failure is still cardiac transplantation. However with ongoing donor organ shortage LVADS have risen to prominence as bridge to transplantation and as destination therapy. The evolution of mechanical circulatory support systems has increased the possibility of extension of life of the native heart for long periods of time with survival times almost comparable with transplants in the first year. It remains unclear if the survival patterns seen overall would extend to the older populations especially greater than 80 years of age. This work is a systematic review of the morbidity and mortality of mechanical heart therapy in this special population.
Methods: Medline/Google scholar and Cochrane database article search was conducted for the period 2000 and 2016.
Results: The small number of patients in this special group is a limitation but suggests the importance of patient selection, family support and perioperative care in this group particularly to achieve comparable survival rates as seen in the younger populations.
Conclusion: Mechanical support can be successful in older populations if patients are well - selected and have adequate family support through their journey with a LVAD.