Left ventricular assist device implantation by bi-thoracotomy technique: A single-center perspective

Area of Science:

• Cardiovascular Surgery
• Medical Devices
• Minimally Invasive Procedures

Background:

• Left ventricular assist device (LVAD) implantation is typically performed via sternotomy.
• Nonsternotomy approaches, such as bi-thoracotomy (BT), are emerging but require further investigation.
• This study compares outcomes of LVAD implantation using BT versus sternotomy.

Purpose of the Study:

• To evaluate if bi-thoracotomy (BT) LVAD implantation leads to smaller and more consistent inflow cannula angles.
• To compare postoperative outcomes between BT and sternotomy approaches for LVAD implantation.
• To investigate potential benefits of the BT approach for LVAD surgery.

Main Methods:

• Retrospective review of LVAD implantation cases between June 2018 and June 2020.
• Comparison of patient demographics, surgical approach (sternotomy vs. BT), laboratory values, and postoperative course.
• Measurement of inflow cannula angle on initial postoperative chest radiographs.

Main Results:

• The bi-thoracotomy (BT) approach was used in 42.5% of the 40 patients studied.
• BT patients had significantly smaller mean inflow cannula angles (23.0 vs. 37.1 degrees) with less variability.
• BT patients required fewer days of postoperative inotropic support (4.0 vs. 7.0 days).

Conclusions:

• LVAD implantation via bi-thoracotomy (BT) results in smaller, more consistent inflow cannula angles.
• The BT approach is associated with a shorter duration of postoperative inotropic support.
• Further research is needed to explore additional benefits of the BT approach for LVAD implantation.