Early experience with baroreflex activation therapy from a vascular surgery perspective

Area of Science:

• Cardiology
• Vascular Surgery
• Medical Device Technology

Background:

• Baroreflex activation therapy (BAT) is an emerging treatment for heart failure with reduced ejection fraction (HFrEF) in patients refractory to medical therapy.
• The role of vascular surgeons in delivering BAT is not well-documented.
• This study addresses the creation of a BAT program and the vascular surgeon's role within a heart failure team.

Purpose of the Study:

• To describe the development of a Baroreflex Activation Therapy program.
• To elaborate on the function of vascular surgeons in the multidisciplinary heart failure team.
• To assess the safety and early outcomes of BAT implantation in HFrEF patients.

Main Methods:

• Retrospective analysis of 11 patients undergoing BAT implantation from March 2022 to August 2023.
• Patients evaluated by cardiologists for medical eligibility and vascular surgeons for technical feasibility.
• Preoperative, perioperative, and postoperative care were analyzed.

Main Results:

• BAT implantation is a safe procedure with no major adverse events or mortality at 6 months.
• Vascular surgeons were integral to the multidisciplinary team, with median surgery time of 82 minutes and 1-day median hospital stay.
• No significant improvements in heart failure disease burden markers were observed within 6 months post-implantation.

Conclusions:

• Baroreflex activation therapy implantation is a safe procedure with a low complication rate.
• Vascular surgeons play a crucial role in the multidisciplinary delivery of this novel device-based therapy.
• Further research is needed to confirm the efficacy of BAT for HFrEF patients refractory to optimal medical therapy.