Perioperative clinical profiles and longitudinal outcomes in patients supported by continuous-flow left ventricular assist devices: a comprehensive analysis of early and late follow-up data

Introduction: Mechanical circulatory support technology, particularly continuous-flow left ventricular assist devices (CF-LVADs), has emerged as a vital therapeutic option for end-stage heart failure (ESHF). However, domestic data on the long-term efficacy and safety of CF-LVADs in real-world settings remain limited, necessitating further investigation to guide clinical practice. Methods: This single-center, retrospective study analyzed 28 patients who underwent CF-LVAD implantation as destination therapy for ESHF between October 2022 and July 2025. One patient died intraoperatively due to severe cardiogenic shock and was excluded from subsequent analyses. The remaining 27 patients (median age: 61 years; 88.9% male) were followed for a median duration of 5.4 months (range: 1.1-35.4 months). Perioperative clinical characteristics, early- and late-term outcomes, including survival, readmission rates, and changes in cardiac and renal/hepatic function, were evaluated. Results: During the follow-up period, significant improvements of liver and renal function were observed, as well as a reduced left ventricular end-diastolic diameter, and an increased left ventricular ejection fraction. Despite these improvements, two deaths occurred during CF-LVAD support, and the hospital readmission rate reached 40.74%. Discussion: CF-LVADs demonstrated promising efficacy in improving hemodynamic and organ function in patients with ESHF. However, the notable readmission rate and mortality highlight the need for optimized patient selection, postoperative management, and long-term monitoring. This study provides critical insights into the real-world challenges and benefits of CF-LVAD therapy, underscoring its value as destination therapy while calling for larger, multicenter studies to validate these findings and further refine clinical protocols.