BACKGROUND: As the technology of ventricular assist devices continues to improve, the morbidity and mortality for patients with a ventricular assist device is expected to approach that of orthotopic heart transplantation. The present study was performed to compare perioperative outcomes, readmission, and resource utilization between ventricular assist device implantation and orthotopic heart transplantation, using a national cohort. METHODS: Patients who underwent either orthotopic heart transplantation or ventricular assist device implantation from 2010 to 2014 in the National Readmission Database were selected. RESULTS: Of the 12,111 patients identified during the study period, 5,440 (45%) received orthotopic heart transplantation, while 6,671 (55%) received ventricular assist devices. Readmissions occurred frequently after ventricular assist device implantation and orthotopic heart transplantation, with greater rates at 30 days (29% versus 24%, P=.005) and 6 months (62% versus 46%, P < .001) for the ventricular assist device cohort. Cost of readmission was greater among ventricular assist device patients at 30 days ($29,115 versus $21,586, P=.0002) and 6 months ($34,878 versus $20,144, P = .0106). CONCLUSION: Readmission rates and costs for patients with a ventricular assist device remain greater than their orthotopic heart transplantation counterparts. Given the projected increases in ventricular assist device utilization and limited transplant donor pool, further emphasis on cost containment and decreased readmissions for patients undergoing a ventricular assist device is essential to the viability of such therapy in the era of value-based health care delivery.
BACKGROUND: As the technology of ventricular assist devices continues to improve, the morbidity and mortality for patients with a ventricular assist device is expected to approach that of orthotopic heart transplantation. The present study was performed to compare perioperative outcomes, readmission, and resource utilization between ventricular assist device implantation and orthotopic heart transplantation, using a national cohort. METHODS: Patients who underwent either orthotopic heart transplantation or ventricular assist device implantation from 2010 to 2014 in the National Readmission Database were selected. RESULTS: Of the 12,111 patients identified during the study period, 5,440 (45%) received orthotopic heart transplantation, while 6,671 (55%) received ventricular assist devices. Readmissions occurred frequently after ventricular assist device implantation and orthotopic heart transplantation, with greater rates at 30 days (29% versus 24%, P=.005) and 6 months (62% versus 46%, P < .001) for the ventricular assist device cohort. Cost of readmission was greater among ventricular assist device patients at 30 days ($29,115 versus $21,586, P=.0002) and 6 months ($34,878 versus $20,144, P = .0106). CONCLUSION: Readmission rates and costs for patients with a ventricular assist device remain greater than their orthotopic heart transplantation counterparts. Given the projected increases in ventricular assist device utilization and limited transplant donor pool, further emphasis on cost containment and decreased readmissions for patients undergoing a ventricular assist device is essential to the viability of such therapy in the era of value-based health care delivery.
Authors: Omar Wever-Pinzon; Yoshifumi Naka; Arthur R Garan; Koji Takeda; Stephen Pan; Hiroo Takayama; Donna M Mancini; Paolo Colombo; Veli K Topkara Journal: J Heart Lung Transplant Date: 2016-03-11 Impact factor: 10.247
Authors: Shannon M Dunlay; Lindsey R Haas; Jeph Herrin; Stephanie R Schilz; John M Stulak; Sudhir S Kushwaha; Nilay D Shah Journal: J Card Fail Date: 2015-06-18 Impact factor: 5.712
Authors: Eric S Weiss; Jeremiah G Allen; Arman Kilic; Stuart D Russell; William A Baumgartner; John V Conte; Ashish S Shah Journal: J Heart Lung Transplant Date: 2011-11-16 Impact factor: 10.247
Authors: William G Cotts; Edwin C McGee; Susan L Myers; David C Naftel; James B Young; James K Kirklin; Kathleen L Grady Journal: J Heart Lung Transplant Date: 2014-03-01 Impact factor: 10.247
Authors: Daniel P Mulloy; Castigliano M Bhamidipati; Matthew L Stone; Gorav Ailawadi; Irving L Kron; John A Kern Journal: J Thorac Cardiovasc Surg Date: 2012-12-13 Impact factor: 5.209
Authors: Tal Hasin; Yariv Marmor; Walter Kremers; Yan Topilsky; Cathy J Severson; John A Schirger; Barry A Boilson; Alfredo L Clavell; Richard J Rodeheffer; Robert P Frantz; Brooks S Edwards; Naveen L Pereira; John M Stulak; Lyle Joyce; Richard Daly; Soon J Park; Sudhir S Kushwaha Journal: J Am Coll Cardiol Date: 2012-12-05 Impact factor: 24.094
Authors: Aayla Jamil; Huanying Qin; Joost Felius; Giovanna Saracino; Aldo E Rafael; Juan C MacHannaford; Gonzalo V Gonzalez-Stawinski; Brian Lima Journal: Am J Cardiol Date: 2017-09-15 Impact factor: 2.778