Impact of Left Ventricular Assist Device Support on Bridging to Transplantation in Adults with Restrictive Cardiomyopathy

s S85 Methods: We reviewed all patients with end-stage RCM who had LVAD implantation from 01/2008 until 08/2013 at our institution. The primary outcome was defined as all-cause mortality or heart transplantation. RCM was defined according to endomyocardial biopsy results or by the presence of echocardiographic characteristics of restrictive physiology. The study cohort consisted of 28 patients (71% males) with end stage RCM (10 Amyloidosis (36%), 8 Hypertrophic cardiomyopathy (28.5%), 5 Sarcoidosis (18%), 4 Chemotherapy or Radiation induced cardiomyopathy (14%) and 1 Fabry disease (3.5%)) who underwent LVAD implantation either as BTT (n= 19, 68%) or destination therapy (DT) (n= 9, 32%). Average age at the time of implant was 57± 13 years. Results: The total 1 year survival was 56% and mean survival time was 547 days, in hospital mortality was 14%. 10 patients underwent heart transplantation with 100% survival during follow up period. Sub analysis to compare amyloid patients vs. non-amyloid patients revealed significant differences in age at implant (66.5±10 vs. 52±11.5, p< 0.05), male gender (10 patients (100%) vs. 10 patients (56%), p< 0.05), left ventricular (LV) end diastolic dimensions (46±10 vs. 58±10 mm, p< 0.05) and in the ratio DT/BTT (n= 6/4 (60%/40%) vs. n= 3/15 (17%/83%), p< 0.05). There were no differences in mean survival time between the groups. Cox regression analysis revealed significant association between LV end diastolic and end systolic dimensions and mortality (RR= 0.94, p< 0.05; RR= 0.95, p< 0.05, respectively). Conclusion: LVAD is a feasible and life saving therapy for end stage heart failure related to RCM especially as a bridge to transplant in patients who would otherwise not survive. Larger LV dimensions may predict improved outcomes following implantation.