Mechanical Circulatory Support Pathways That Maximize Post-Heart Transplant Survival Tara Karamlou, MD, MS, Jill Gelow, MD, Brian S. Diggs, PhD, Frederick.

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Mechanical Circulatory Support Pathways That Maximize Post-Heart Transplant Survival Tara Karamlou, MD, MS, Jill Gelow, MD, Brian S. Diggs, PhD, Frederick A. Tibayan, MD, James M. Mudd, MD, Steven W. Guyton, MD, Matthew S. Slater, MD, Howard K. Song, MD, PhD The Annals of Thoracic Surgery Volume 95, Issue 2, Pages 480-485 (February 2013) DOI: 10.1016/j.athoracsur.2012.05.108 Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Risk-unadjusted posttransplant survival stratified support type at the time of transplantation is shown in this Kaplan-Meier plot. Support types are shown by colored lines, including inotropes (purple), left ventricular assist device (LVAD [brown]), biventricular assist device (BiVAD [red]), extracorporeal membrane oxygenation (ECMO [blue]), and right ventricular assist device (RVAD [green]). Patients on LVAD support had significantly better posttransplant survival compared with patients on all other types of mechanical circulatory support. Note that, before risk adjustment, the LVAD curve and the inotrope curve are statistically equivalent. The Annals of Thoracic Surgery 2013 95, 480-485DOI: (10.1016/j.athoracsur.2012.05.108) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Time-related survival after transplant is shown in this Kaplan-Meier plot. Two selected trajectories (dashed lines) demonstrate patients who transitioned from either extracorporeal membrane oxygenation (ECMO) or biventricular assist device (BiVAD) support to left ventricular assist device (LVAD) only support at transplantation. These groups, despite initial requirement of BiVAD support, had recovery of posttransplant survival to levels approximating those of patients who had LVAD-only therapy throughout their course (p = 0.74). (RVAD = right ventricular assist device.) The Annals of Thoracic Surgery 2013 95, 480-485DOI: (10.1016/j.athoracsur.2012.05.108) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions