{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T10:19:30Z","timestamp":1789121970114,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T00:00:00Z","timestamp":1612137600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The use of left ventricular assist devices (LVADs) for advanced heart failure is becoming increasingly common. However, optimal timing and patient selection remain controversial. The aim of this study was to investigate outcomes of LVAD implantation for advanced heart failure in critically ill patients (INTERMACS 1 and 2). Between August 2010 and January 2020, 207 consecutive patients underwent LVAD implantation. Overall survival, major adverse events, and laboratory parameters were compared between patients in INTERMACS 1\u20102 (<jats:italic>n<\/jats:italic>\u00a0=\u00a0107) and INTERMACS 3\u20105 (<jats:italic>n<\/jats:italic>\u00a0=\u00a0100). Preoperative white blood cells, C\u2010reactive protein, procalcitonin, bilirubin, alanine transaminase, and lactate dehydrogenase were all significantly higher in INTERMACS 1\u20102 when compared to INTERMACS 3\u20105 (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05). During hospitalization following LVAD implantation, patients in INTERMACS 1\u20102 were more likely to develop major infections (41.1% vs. 23.0%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.005), respiratory failure (57.9% vs. 25.0%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001), mild (20.6% vs. 8.0%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.010), and moderate (31.8% vs. 7.0%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) right heart failure, and acute renal dysfunction (56.1% vs. 6.0%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). During a median follow\u2010up of 2.00 years (interquartile range (IQR) 0.24\u20103.39 years), they had a higher incidence of thoracic (15.9% vs. 4.0%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.005) and gastrointestinal bleeding (21.5% vs. 11.0%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.042), as well as right heart failure (18.7% vs. 1%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). Risk of death was significantly higher in the INTERMACS 1\u20102 group (hazards ratio (HR) 1.64, 95% CI 1.12\u20102.40, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.011). LVAD implantation in critically ill patients is associated with increased morbidity and mortality. Our results suggest that decision for LVAD should be not be delayed until INTERMACS 1 and 2 levels whenever possible.<\/jats:p>","DOI":"10.1111\/aor.13897","type":"journal-article","created":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T21:10:35Z","timestamp":1608671435000},"page":"706-716","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Outcomes of left ventricular assist device implantation for advanced heart failure in critically ill patients (INTERMACS 1 and 2): A retrospective study"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6440-3736","authenticated-orcid":false,"given":"Konstantin","family":"Zhigalov","sequence":"first","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery West German Heart and Vascular Center Essen University Hospital of Essen University Duisburg\u2010Essen Essen Germany"},{"name":"International Thoracic and Cardiovascular Research Association (ITCVR)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5606-376X","authenticated-orcid":false,"given":"Jef","family":"Van den Eynde","sequence":"additional","affiliation":[{"name":"International Thoracic and Cardiovascular Research Association (ITCVR)"},{"name":"Department of Cardiovascular Sciences Unit of Cardiac Surgery University Hospitals Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Chrosch","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery West German Heart and Vascular Center Essen University Hospital of Essen University Duisburg\u2010Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Goerdt","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery West German Heart and Vascular Center Essen University Hospital of Essen University Duisburg\u2010Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel Pompeu Barros Oliveira","family":"S\u00e1","sequence":"additional","affiliation":[{"name":"International Thoracic and Cardiovascular Research Association (ITCVR)"},{"name":"Department of Cardiovascular Surgery Pronto Socorro Cardiol\u00f3gico de Pernambuco (PROCAPE) Recife PE Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2444-5747","authenticated-orcid":false,"given":"Alina","family":"Zubarevich","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery West German Heart and Vascular Center Essen University Hospital of Essen University Duisburg\u2010Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2801-7942","authenticated-orcid":false,"given":"Maria","family":"Papathanasiou","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Vascular Medicine West German Heart and Vascular Center Essen University Hospital of Essen University Duisburg\u2010Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Wendt","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery West German Heart and Vascular Center Essen University Hospital of Essen University Duisburg\u2010Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Luedike","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Heart Center Essen Huttrop University Hospital Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaus","family":"Pizanis","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery West German Heart and Vascular Center Essen University Hospital of Essen University Duisburg\u2010Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achim","family":"Koch","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery West German Heart and Vascular Center Essen University Hospital of Essen University Duisburg\u2010Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bastian","family":"Schmack","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery West German Heart and Vascular Center Essen University Hospital of Essen University Duisburg\u2010Essen Essen Germany"},{"name":"International Thoracic and Cardiovascular Research Association (ITCVR)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tienush","family":"Rassaf","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Vascular Medicine West German Heart and Vascular Center Essen University Hospital of Essen University Duisburg\u2010Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Kamler","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Heart Center Essen Huttrop University Hospital Essen Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjang","family":"Ruhparwar","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery West German Heart and Vascular Center Essen University Hospital of Essen University Duisburg\u2010Essen Essen Germany"},{"name":"International Thoracic and Cardiovascular Research Association 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