Association between the low percentage of forced vital capacity and increased mortality after left ventricular assist device implantation

Background This study aims to investigate the effect of low percentage of forced vital capacity measured in the preoperative period on the 28-day mortality in patients undergoing left ventricular assist device implantation. Methods A total of 131 patients (111 males, 20 females; median age 54 years; range, 47 to 59 years) who underwent left ventricular assist device implantation with HeartWare™ between December 2010 and January 2016 were retrospectively analyzed. The patients were divided into two groups according to the results of pulmonary function test as a forced vital capacity percentage of ≥60% (n=113) and <60% (n=18). Both groups were compared in terms of laboratory and clinical characteristics, and postoperative complications. Risk factors for postoperative 28-day mortality were analyzed. Results Pre- and intraoperative characteristics were similar in both groups, except for left ventricular end-diastolic diameter. The ventilator-free days up to 28 days was shorter (p=0.046) and the length of intensive care unit stay was longer (p=0.011) in the low percentage of forced vital capacity group. The 28-day mortality rate was also higher (22.2% vs. 9.7%, respectively; p=0.12) in this group. The history of prior cardiac operation (odds ratio: 4.40; 95% confidence interval 1.19-16.20, p=0.026) and tricuspid valve repair at the time of device implantation (odds ratio: 5.30; 95% confidence interval 1.33-21.00, p=0.018) were found to be independent risk factors for mortality. Multivariate analysis showed that a forced vital capacity of <60% was not associated with mortality (odds ratio: 3.96; 95% confidence interval 0.95-16.43, p=0.058). Conclusion The length of intensive care unit stay and duration of mechanical ventilation may be longer in patients with a low percentage of forced vital capacity. Although the association between 28-day mortality and low percentage of forced vital capacity is not significant, the risk of 28-day mortality is higher in this group. Therefore, the patients should be assessed carefully before the left ventricular assist device operation.