Do Women Have Inferior Outcomes to Men after LVAD Implantation- A Propensity-Matched Comparison

Purpose Examine gender differences continuous-flow left ventricular assist device (CF-LVAD) recipients. Methods Retrospective review of 695 patients receiving a CF-LVAD from 11/2003 to 08/2017, of which 551 (79.3%) were male and 144 (20.7%) were female. Genders were compared after propensity score matching for age ≥50 yrs, diagnosis, body surface area, INTERMACS class, comorbidities, prior mechanical circulatory support, and prior sternotomy. Survival and outcomes were compared between 139 matched gender pairs. Results After matching, no difference was seen in baseline characteristics (Table 1). A competing risk analysis showed that women had a non-significant increase in mortality (p=0.065) (Figure 1). Women had higher rates of right ventricular assist device support (3.4% vs 0.8%, p=0.03) and there was a trend towards higher rates of stroke, LVAD exchange, and longer length of stay. Additionally, lower rates of drive line infection and transplantation in women were seen (Table 2). Conclusion Larger studies are needed to determine if these single center findings of increased probability of mortality amongst women are reproducible. Additionally, further study should be devoted to risk factors for postoperative right heart failure among women.