What question did this study set out to answer?

This study aims to determine the rates and causes of readmissions following axial flow LVAD implantation.

May 15, 2026

Readmissions After Implantation of Axial Flow Left Ventricular Assist Device

Key Points

This study aims to determine the rates and causes of readmissions following axial flow LVAD implantation.
Retrospective analysis of 115 patients implanted with HeartMate II LVAD from January 2008 to July 2011.
Used Andersen-Gill models to identify possible predictors of readmissions after surgery.
Followed patients for an average of 1.4 years post-implantation.
Total of 224 readmissions among 83 patients, with an overall rate of 1.64 readmissions per patient-year.
Initial 6-month readmission rate was 2.0, decreasing to 1.2 in subsequent follow-up periods.
Leading causes included 66 bleeding-related readmissions, 51 cardiac events, 32 infections, and 20 thrombosis-related events.

Abstract

OBJECTIVES: The purpose of this study was to determine the occurrence and causes of readmissions after implantation of axial flow left ventricular assist device (LVAD). BACKGROUND: Based on the REMATCH (Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure) study experience, readmissions after LVAD implantation are thought to be frequent. METHODS: We retrospectively analyzed admissions to our facility in a cohort of 115 patients implanted between January 2008 and July 2011 with the HeartMate II axial flow LVAD, of whom 42 were bridged to transplant. To account for repeated events, Andersen-Gill models were used to determine possible predictors. RESULTS: The patients were followed for 1.4 ± 0.9 years. There were 224 readmissions in 83 patients. The overall readmission rate was 1.64 ± 1.97 per patient-year of follow-up. The readmission rate for the first 6 months was 2.0 ± 2.3 and decreased to 1.2 ± 2.1 during subsequent follow-up. Leading causes were bleeding (66 readmissions in 34 patients), mostly gastrointestinal bleed (51 in 27 patients), cardiac (51 in 36 patients, most for HF or arrhythmia), infections (32 in 25 patients) of which 6 were pump related, and thrombosis (20 in 15 patients) including 13 readmissions due to hemolysis. Preoperative variables associated with (fewer) readmissions in a multivariate model include residence within our hospital-extended referral zone of Minnesota and the neighboring states (hazard ratio: 0.66; 95% confidence interval: 0.48 to 0.91; p = 0.011), hemoglobin (hazard ratio: 0.91, 95% confidence interval: 0.84 to 0.99; p = 0.027) and N-terminal pro-B-type natriuretic peptide (hazard ratio: 0.98; 95% confidence interval: 0.96 to 1.0 per 1,000-unit increase, p = 0.022). C-statistic for the model: 0.63. CONCLUSIONS: Readmission rates after axial flow LVAD implantation decrease during the first 6 months and then stabilize. The leading causes are bleeding, cardiac (heart failure and arrhythmia), infections, and thrombosis.

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