S216 The Journal of Heart and Lung Transplantation, Vol 34, No 4S, April 2015 ( 578) Poor Pre-Operative Pulmonary Function Tests (PFTs) Do Not Predict Worse Outcomes in Patients Undergoing LVAD Placement F. Kamdar , 1 N. Sathnur, 1 D. Nieto, 2 A. Klaassen Kamdar, 1 K. Liao, 1 P.M. Eckman, 1 R. John. 1 1 University of Minnesota, Minneapolis, MN; 2 Baylor College of Medicine, Houston, TX. Purpose: Poor preoperative pulmonary function has been identified as a risk factor for poor outcomes following cardiac surgery, but this has not been well described in patients undergoing LVAD placement. The objective is to examine the relationship between preoperative pulmonary function and outcomes after LVAD implantation. Methods: We evaluated patients who underwent HeartMate II as intent for BTT at a single center from 10/2005 to 7/2014. Moderate to severe obstruc- tive pulmonary disease was defined as a forced expiratory volume in 1s (FEV1) to forced vital capacity ratio (FEV1/FVC) <0.7 and FEV1 <80%. Results: 183 patients were evaluated; of these, 122 had preoperative PFTs; 61 patients had PFTs deferred due to heart failure exacerbation. Of these 122 patients, 47 had moderate to severe obstructive PFTs (group 1) and 75 patients had normal to mild obstructive PFTs. The mean % predicted FEV1 was 56 ± 12L in group 1 and 72± 17L (p = 0.001) in group 2. The FEV1/ FVC ratio was 0.63 ± 0.1 in group 1 and 0.80 ± 0.05 in group 2 (p = 0.0001). There were no significant differences in age, etiology, gender, INTERMACS profiles, or baseline hemodynamics (p = NS). Patients in group 1 were signif- icantly more likely to have a smoking history (64% vs 35%, p =0.03) higher pack years of smoking (39 vs 23, p = 0.02), and prior history of COPD (23% vs 5%, 0.004). There was no significant differences in days of ventilation, reintubation, right heart failure, ICU length of stay, length of stay, or LVAD duration of support between group 1 or 2 (p = NS). Actuarial survival at 1 year was 81% in group 1 and 89.5% in group 2 (log rank p = NS). Conclusion: Patients with moderate to severe obstruction on PFTs prior to LVAD placement do not have worse outcomes than those patients with nor- mal PFTs. In patients with end-stage heart failure, poor pulmonary function may be a reflection of decompensated heart failure. Therefore, poor PFTS should not be considered an absolute contraindication to LVAD placement. ( 579) Mechanical Circulatory Support Is Feasible and Safe as Bridge to Transplant for Patients With Restrictive and Hypertrophic Cardiomyopathy S. Al-Kindi, M. Ige , S. Kumar, C. ElAmm, M. Ginwalla, S. Deo, S.J. Park, G.H. Oliveira. University Hospitals Case Medical Center, Cleveland, OH. Purpose: Small case series have described use of mechanical circulatory support (MCS) in selected patients with hypertrophic and restrictive cardio- myopathy (HCM/RCM). We sought to investigate the use of MCS in these patients as bridge to transplant and describe their post-transplant outcomes. Methods: We queried the UNOS database for all adult patients (age > 18) with hypertrophic or restrictive cardiomyopathy who are bridged with left ventricular assist devices (LVAD) or biventricular assist devices (BiVAD) to heart transplantation (2004-2013) and compared their characteristics and outcomes to those without LVADs/BiVADs. Results: We identified 108 patients with hypertrophic cardiomyopathy (n=54) and restrictive cardiomyopathy (n=54) bridged with LVAD (n=88) or BiVAD (n=20) to transplantation and 815 patients with HCM (n=351) or RCM (n=464) without MCS. Compared with medically bridged patients, those with LVADs were more likely to be male (57.8% vs 71.6%, p=0.015), have ICD (62.0% vs. 85.1%, p<0.001), and be listed as status 1a (38.4% vs. 75.0%, p<0.001), have longer wait time (167.4 vs. 273.6, p=0.003), but less likely to use inotropes (52.1% vs. 18.2%, p<0.001). Patients with BiVADs were less likely to have ICDs (62.0% vs.35.0%, p<0.019), more likely to be listed as 1a (38.4% vs.90.0%, p<0.001), and less likely to use inotropes (52.1% vs.5.0%, p<0.001), and have lower serum creatinine (1.32 vs. 1.05, p=0.006), and lower cardiac output (3.9 vs. 3.1, p=0.021). There was no difference in post-transplant survival between HCM/RCM patients bridged medically, with LVADs (p=0.46) or BiVADs (p=0.75), figure 1. Conclusion: A small proportion of patients with hypertrophic and restric- tive cardiomyopathy may require bridging with MCS. MCS use in patients with HCM/RCM awaiting transplantation is feasible and does not affect post-transplant survival. demonstrate feasibility and efficacy of VT ablation in this population, and to determine how often ablation is required around the LVAD inflow cannula. Methods: We reviewed the procedural characteristics and clinical outcomes of consecutive LVAD patients who underwent ablation for medically-refractory VT at our institution. Results: 11 patients (10 HeartMate II, 1 HeartWare HVAD) underwent VT ablation. Median time to ablation post-LVAD was 77 days -- 3 underwent “early” ablation (<30 days post-LVAD implant). All patients were male and had ischemic cardiomyopathy. Mean LVEF was 17%. Setup: Mapping and ablation was performed via transseptal access in 8 patients and retrograde aortic access in 3. Irrigated ablation was employed in all cases. Catheter shaft contact with the LVAD inflow cannula at times interfered with 3D mapping using CARTO but not ESI. Mapping: Detailed maps were available for 9 patients. Dense scar (bipolar voltage <0.5 mV) represented 26.1 +/- 9.8% of the endocardial surface, and border zone (bipolar voltage 0.5 - 1.5 mV) 36.2 +/- 14.2%. Distribution of myocardial scar was anterior in 7 patients, septal in 7, lateral in 5, and/ or inferior in 8. There was basal LV scar in 7 patients and apical scar in 7. Ablation: 6 patients had >3 inducible VTs, 4 had 2-3 VTs, and 1 had a single VT. Mapping strategies included entrainment in all patients, pace-mapping in 64%, and substrate mapping in 73%. Ablation near the LVAD inflow cannula was required in 1 of 3 (33%) early post-LVAD ablations and 3 of 8 (38%) late ablations (P=NS). Outcomes: Procedure endpoints included termination of the clinical VT with ablation (7 patients), inducibility for only non-clinical VT or VF (5), and non- inducibility with double extrastimuli (2). There were no major complications. 7 patients remained free from ICD shocks at 6 months (64%). All-cause mortality was 18% at 3 months and 36% at 1 year. Conclusion: VT ablation is safe and effective in preventing ICD therapies in patients who have undergone prior LVAD implantation. For the majority of patients with ischemic cardiomyopathy, ablation near the LVAD inflow cannula is not necessary. One year mortality in this population remains high. ( 577) Incidence of Gastrointestinal Bleeds in Patients With Continuous-Flow Left Ventricular Assist Devices Prescribed Serotonergic Agents J. Schultz , 1 H. Bream-Rouwenhorst, 1 R. Hobbs, 1 D. McDanel, 1 J. Goerbig- Campbell. 2 1 Department of Pharmaceutical Care, The University of Iowa Hospitals and Clinics, Iowa City, IA; 2 Department of Internal Medicine - Cardiovascular Care, The University of Iowa Hospitals and Clinics, Iowa City, IA. Purpose: Acquired von Willebrand disease, development of arteriovenous malformations, and requiring lifelong anticoagulation to prevent pump thrombosis are risk factors for gastrointestinal (GI) bleeding in patients with continuous-flow left ventricular assist devices (CF LVADs). In addition, depression is common in the heart failure population, and select serotonergic agents (SAs) are a first-line treatment. SAs have been associated with an increased incidence of GI bleeds. We hypothesized that SA use is associated with an increased risk of GI bleeds in patients implanted with CF LVADs. Methods: A retrospective, observational cohort study was performed of all patients implanted with CF LVADs at our institution from May 2009 through October 2013. The primary outcome measure was the incidence of GI bleeds in patients with LVADs concomitantly using SAs versus those not using SAs. Results: Sixty-four patients were included. The mean age was 56 years, 69% were male, 86% were on aspirin and 94% were on warfarin at the time of first GI bleed. Twenty-one patients experienced GI bleeding, and 15 (71%) patients were using SAs. Conversely, only 18 (42%) of the 43 patients that did not have a bleed were concurrently using an SA. The unadjusted relative risk of experiencing a GI bleed while using an SA was 2.4 [95% CI 1.05 - 5.28; p=0.026]. A multivariate logistic regression analysis adjusting for age and gender was performed. The adjusted odds ratio of experiencing a GI bleed while using an SA was 2.8 [95% CI 1.19 - 12.13; p=0.024]. Since nearly uniform use of aspirin and warfarin resulted in insufficient variability between the study groups, these variables were excluded from the multivari- ate logistic regression analysis. Conclusion: Serotonergic agents are associated with an increased risk of GI bleeding in patients implanted with CF LVADs. To confirm these results, our research group plans to evaluate an expanded patient population.