Article, 2022

The European Registry for Patients with Mechanical Circulatory Support of the European Association for Cardio-Thoracic Surgery: third report.

In: European Journal of Cardio-Thoracic Surgery, ISSN 1873-734X, 10.1093/ejcts/ezac032

Contributors (40)

De By, Theo M M H (0000-0001-8991-3348) [1] Schoenrath, Felix [2] [3] Veen, Kevin M (0000-0003-2806-8384) [4] Mohacsi, Paul [5] Stein, Julia [2] [3] Alkhamees, Khalid M M [6] Anastasiadis, Kyriakos (0000-0001-7837-3446) [7] Berhnardt, Alexander [8] Beyersdorf, Friedhelm (0000-0003-2975-2751) [9] [10] Caliskan, Kadir C (0000-0002-3293-9261) [4] Reineke, David [11] Damman, Kevin (0000-0003-0190-2228) [12] Fiane, Arnt Eltvedt [13] Gkouziouta, Angeliki (0000-0003-2743-9585) [14] Gollmann-Tepeköylü, Can (0000-0001-6584-3488) [15] Finn, Gustafsson [16] Hulman, Michal [17] Iacovoni, Attilio [18] Loforte, Antonio (0000-0002-3689-0477) [19] Merkely, Bela [20] Musumeci, Francesco [21] Němec, Petr [8] Netuka, Ivan (0000-0002-1567-7036) [22] Ozbaran, Mustafa (0000-0003-0259-0799) [23] Potapov, Evgenij V [2] [3] Pya, Yuri [24] Rábago, Gregorio (0000-0003-1936-6881) [25] Ramjankhan, Faiz [26] Reichenspurner, Hermann C [27] Saeed, Diyar (0000-0001-7449-9455) [28] Sandoval, Elena [29] Stockman, Bernard [30] Vanderheyden, Marc [30] Tops, Laurens F [31] Wahlers, Thorsten [32] Zembala, Michael [33] Zimpfer, Daniel [34] Carrel, Thierry [35] Gummert, Jan Fritz [36] Meyns, Bart [37]

Affiliations

  1. [1] EUROMACS, EACTS House, Windsor, UK.
  2. [2] Deutsches Herzzentrum Berlin
  3. [NORA names: Germany; Europe, EU; OECD]
  4. [3] German Centre for Cardiovascular Research
  5. [NORA names: Germany; Europe, EU; OECD]
  6. [4] Erasmus MC
  7. [NORA names: Netherlands; Europe, EU; OECD]
  8. [5] HerzZentrum Hirslanden, Zürich, Switzerland.
  9. [6] Prince Sultan Cardiac Center Al Hassa, Saudi Arabia.
  10. [7] Cardiothoracic Dept, AHEPA University Hospital, Aristotle University, Thessaloniki, Greece.
  11. [8] Center for Cardiovascular Surgery and Transplantation Surgery Brno, Brno, Czech Republic.
  12. [9] University Medical Center Freiburg
  13. [NORA names: Germany; Europe, EU; OECD]
  14. [10] University of Freiburg
  15. [NORA names: Germany; Europe, EU; OECD]
  16. [11] University Hospital of Bern
  17. [NORA names: Switzerland; Europe, Non-EU; OECD]
  18. [12] University Medical Center Groningen
  19. [NORA names: Netherlands; Europe, EU; OECD]
  20. [13] Oslo University Hospital
  21. [NORA names: Norway; Europe, Non-EU; Nordic; OECD]
  22. [14] Onassis Cardiac Surgery Center
  23. [NORA names: Greece; Europe, EU; OECD]
  24. [15] University Hospital Innsbruck
  25. [NORA names: Austria; Europe, EU; OECD]
  26. [16] Rigshospitalet
  27. [NORA names: Capital Region of Denmark; Hospital; Denmark; Europe, EU; Nordic; OECD]
  28. [17] Klinika Kardiochirurgie NUSCH, Bratislava, Slovakia.
  29. [18] Ospedale Papa Giovanni XIII, Bergamo, Italy.
  30. [19] San Orsola Hospital, Bologna, Italy.
  31. [20] Semmelweis University
  32. [NORA names: Hungary; Europe, EU; OECD]
  33. [21] Azienda Ospedaliera San Camillo-Forlanini
  34. [NORA names: Italy; Europe, EU; OECD]
  35. [22] Institute of Clinical and Experimental Medicine
  36. [NORA names: Czechia; Europe, EU; OECD]
  37. [23] Ege Üniversitesi Tıp Fakültesi Hastanesi
  38. [NORA names: Turkey; Asia, Middle East; OECD]
  39. [24] National Research Cardiac Surgery Center, Astana, Kazakhstan.
  40. [25] Clinica Universidad de Navarra
  41. [NORA names: Spain; Europe, EU; OECD]
  42. [26] University Medical Center Utrecht
  43. [NORA names: Netherlands; Europe, EU; OECD]
  44. [27] University Medical Center Hamburg-Eppendorf
  45. [NORA names: Germany; Europe, EU; OECD]
  46. [28] University Hospital Leipzig
  47. [NORA names: Germany; Europe, EU; OECD]
  48. [29] ESPAMACS, Sociedad Española de Cirugía Cardiovascular y Endovascular (SECCE), Madrid, Spain.
  49. [30] Onze Lieve Vrouwenziekenhuis, Aalst, Belgium.
  50. [31] Leiden University Medical Center
  51. [NORA names: Netherlands; Europe, EU; OECD]
  52. [32] University Hospital Cologne
  53. [NORA names: Germany; Europe, EU; OECD]
  54. [33] Silesian Center for Heart Disease
  55. [NORA names: Poland; Europe, EU; OECD]
  56. [34] Medical University of Vienna
  57. [NORA names: Austria; Europe, EU; OECD]
  58. [35] University Hospital of Zurich
  59. [NORA names: Switzerland; Europe, Non-EU; OECD]
  60. [36] Heart and Diabetes Center North Rhine-Westphalia
  61. [NORA names: Germany; Europe, EU; OECD]
  62. [37] KU Leuven
  63. [NORA names: Belgium; Europe, EU; OECD]

Abstract

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.