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Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
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Minimally Invasive Left Ventricular Assist Device Implantation: A Comparative Study
Prashant N Mohite1, Anton Sabashnikov1,2, Binu Raj1
1Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Harefield Hospital, Harefield, Uxbridge, UK.
Artificial Organs
|November 17, 2018
Summary
Minimally invasive thoracotomy for left ventricular assist device (LVAD) implantation shows similar survival to sternotomy but reduces the need for temporary right ventricular assist. This approach spares the sternum and may prevent right ventricular dilation.
Area of Science:
- Cardiology
- Cardiac Surgery
- Medical Technology
Background:
- Left ventricular assist device (LVAD) implantation is a standard treatment for advanced heart failure.
- Minimally invasive thoracotomy offers potential advantages over conventional sternotomy, including sternal sparing for reduced re-operation risk.
Purpose of the Study:
- To compare the outcomes of LVAD implantation using a minimally invasive thoracotomy approach versus a conventional sternotomy approach.
- To determine the superiority of one surgical approach over the other in terms of patient outcomes and complications.
Main Methods:
- A retrospective analysis of 205 continuous flow LVAD implantations.
- Patients were divided into two groups: sternotomy (n=180) and thoracotomy (n=25).
- Comparison of preoperative and postoperative parameters, including hemodynamics, laboratory markers, bleeding, resource utilization, complications, and long-term survival.
Main Results:
- No significant differences were observed in patient demographics, preoperative/postoperative parameters, bleeding, resource utilization, or complications between the groups.
- Long-term survival rates were comparable between the thoracotomy and sternotomy groups (Log-Rank P=0.953).
- The thoracotomy group required significantly less temporary right ventricular assist (4% vs. 19.4%, P=0.041).
Conclusions:
- Minimally invasive bilateral thoracotomy for LVAD implantation provides comparable long-term survival to sternotomy.
- This approach offers the benefit of sternal sparing and may reduce the incidence of right ventricular failure requiring temporary support.
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