Left Ventricular Assist Device Therapy in Heart Failure: A Meta-Analysis

Abstract

he current treatment options available for end-stage heart failure include heart transplantation (HTx) and left ventricular assist devices (LVADs). Despite comparable efficacy and safety profiles, the reliability of LVAD therapy as an alternative to the standard HTx still controversial. Moreover, the choice among different LVADs types in candidate patients is unclear. The current study aims to compare HTx vs LVADs in adult end stage heart failure population, evaluate destination therapy (DT) vs bridge to therapy (BTT) as indications for LVADS, and characterizes individual safety profiles for commercially available LVADs including HeartWare, HeartMate II, and HeartMate III. A systematic search of Egyptian knowledge bank (EKB), PubMed, and Cochrane databases was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Four types of comparisons were set in the current analysis: HTx vs LVADs, DT vs BTT, HeartWare vs HeartMate II, and HeartMate II vs HeartMate III. The primary endpoint assessed was the all-cause mortality. Secondary endpoints were the complication rates relevant to either modality including organ failure, infection rates and device related complications (for LVADs only).