{
  "abstract": "Objectives: Superior survival outcomes have been reported for younger patients receiving durable left ventricular assist devices (LVADs) in Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS). We explored whether these findings extend to contemporary European practice leveraging on EUROMACS (European Registry for Patients with Mechanical Circulatory Support).\n\nMethods: Adult patients undergoing implantation of current-generation magnetically levitated LVADs in EUROMACS were stratified according to age groups. The primary outcome was 5-year on-device survival, censored at heart transplantation (HT) or LVAD explantation. Secondary outcomes included LVAD explant for myocardial recovery and survival free from major adverse events (bleeding, stroke, device-related infection, or device malfunction). Death incidence accounting for HT and support cessation as competing risks was also calculated.\n\nResults: A total of 2850 patients undergoing HeartMate 3 implantation were included (<50 years: 23.5%; 50-59 years: 29.7%; 60-69 years: 38.0%; ≥70 years: 8.8%). Younger patients had fewer comorbidities, a higher prevalence of non-ischaemic cardiomyopathy, and INTERMACS profile ≤3. Younger patients had superior on-device 5-year survival (<50 years: 74.7%; 50-59 years: 65.5%; 60-69 years: 53.9%; ≥70 years: 48.8%; P < .001) and LVAD explantation for myocardial recovery (<50 years: 4.3%; 50-59 years: 1.8%; 60-69 years: 2.3%; ≥70 years: 0.4%; P = .031). Accounting for competing outcomes, the 5-year cumulative incidence of death was lowest among younger patients (<50 years: 20.8%; 50-59 years: 29.1%; 60-69 years: 40.8%; ≥70 years: 49.5%; P < .001), driven by higher HT rates. Survival free from bleeding was significantly higher in younger patients (P < .001). In contrast, 5-year freedom from stroke, device-related infection, and device malfunction was similar across age groups.\n\nConclusions: In contemporary European practice, patients <50 years undergoing LVAD implant had high 5-year survival approaching that reported in cohorts of patients listed for HT. These findings support further investigation of prolonged LVAD support before HT as a potential strategy to maximize lifetime benefit in selected motivated younger candidates.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 24,
  "authors": [
    {
      "name": "Guglielmo Gallone"
    },
    {
      "name": "Kevin M Veen"
    },
    {
      "name": "Alexander M Bernhardt",
      "orcid": "0000-0001-9974-8091"
    },
    {
      "name": "Kadir Caliskan"
    },
    {
      "name": "Emil Najjar"
    },
    {
      "name": "Ivan Netuka"
    },
    {
      "name": "Anna Mara Scandroglio"
    },
    {
      "name": "Antonio Spitaleri"
    },
    {
      "name": "Diego Sangiorgi"
    },
    {
      "name": "Peter Ivak",
      "orcid": "0000-0002-1803-604X"
    },
    {
      "name": "Arnt Fiane"
    },
    {
      "name": "Feras Khaliel"
    },
    {
      "name": "Mustafa Özbaran",
      "orcid": "0000-0003-0259-0799"
    },
    {
      "name": "Yuri Pya",
      "orcid": "0000-0001-7249-0510"
    },
    {
      "name": "Daniel Zimpfer",
      "orcid": "0000-0002-2185-4895"
    },
    {
      "name": "Gloria Färber"
    },
    {
      "name": "Jan Gummert"
    },
    {
      "name": "Bart Meyns",
      "orcid": "0000-0002-8110-4009"
    },
    {
      "name": "Paola Quattroni",
      "orcid": "0000-0001-7620-8981"
    },
    {
      "name": "Felix Schoenrath",
      "orcid": "0000-0002-8221-1295"
    },
    {
      "name": "Gaetano Maria De Ferrari",
      "orcid": "0000-0003-4940-0876"
    },
    {
      "name": "Mauro Rinaldi"
    },
    {
      "name": "Evgenij Potapov"
    },
    {
      "name": "Antonio Loforte",
      "orcid": "0000-0002-3689-0477"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fm6b5scnd8h6n.bib",
  "cited_by": 0,
  "doi": "10.1093/ejcts/ezag234",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13735509/",
  "id": "fm6b5scnd8h6n",
  "issns": [
    "1010-7940",
    "1873-734X"
  ],
  "landing_url": "https://doi.org/10.1093/ejcts/ezag234",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "AcademicSubjects/MED00920"
    ],
    [
      "heading",
      "Eacts/111"
    ],
    [
      "heading",
      "Eacts/118"
    ],
    [
      "heading",
      "Original Article"
    ],
    [
      "heading",
      "Tx & Mcs"
    ],
    [
      "openalex",
      "2705|Mechanical Circulatory Support Devices"
    ]
  ],
  "openalex": "W7221052041",
  "pdf_url": "https://academic.oup.com/ejcts/advance-article-pdf/doi/10.1093/ejcts/ezag234/71666848/ezag234.pdf",
  "pmcid": "PMC13735509",
  "pmid": "42842428",
  "published": "2026-10-07",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/fm6b5scnd8h6n.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:21:10Z",
      "native_id": "PMC13735509",
      "source": "pmc",
      "url": "https://doi.org/10.1093/ejcts/ezag234"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Mechanical Circulatory Support Devices",
      "subfield": "cardiovascular"
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  ],
  "title": "Long-Term Outcomes of Contemporary Durable Left Ventricular Assist Device Support in Younger Patients: A EUROMACS Analysis",
  "title_text": "Long-Term Outcomes of Contemporary Durable Left Ventricular Assist Device Support in Younger Patients: A EUROMACS Analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:21:10Z",
  "url": "https://research.draconitic.com/paper/fm6b5scnd8h6n",
  "venue": "European Journal of Cardio-Thoracic Surgery",
  "versions": []
}